Fraud is the intentional deception to secure unfair or unlawful gain, or to deprive a victim of a legal right. It has been estimated that over $60 billion a year is lost to health care fraud schemes.
Johns Hopkins Medicine Employer Health Programs (EHP) is dedicated to protect the integrity of the care its members receive. The mission of the Special Investigations Unit (SIU) is to identify and stop instances of fraud. With decades of experience in fraud investigations, members of this unit are uniquely equipped for this role. We are asking for YOU to join us by taking an active role in the fight against fraud.
Some examples of health care fraud you may encounter and should report are:
- A Provider billing for services they did not render or for products they did not provide.
- A Provider billing for products or services that are not medically necessary.
- A Patient selling or diverting prescription medicine or items provided under the Johns Hopkins Medicine Employer Health Program.
- A Patient obtaining many prescriptions for the same drug from several doctors during the same time period.
- Any individual forging or changing prescription forms.
How Can I Help?
You can help reduce health care fraud by following these simple rules:
- Never loan your EHP insurance card to anyone;
- Report all suspicions of fraud; and
- Report lost or stolen insurance cards to the EHP Customer Service Department at 800-261-2393 or 410-424-4450.
Remember health care fraud affects everyone. If you believe someone is committing fraud against Johns Hopkins Medicine Employer Health Programs, please report the act to the EHP Compliance Department. You can remain nameless, and all reports are kept confidential. JHHC is committed to following all applicable laws and regulations, in particular those that address health care fraud, waste and abuse and the improper billing of health care services.
What happens to me if I report a concern?
Johns Hopkins HealthCare takes its responsibility to protect your ‘right to report’ seriously! No JHHC employee may threaten, coerce, harass, retaliate, or discriminate against any individual who reports a compliance concern. To support this effort, the Health Plan has enacted zero-tolerance policies and annually trains all personnel on their obligation to maintain the highest integrity when handling compliance related matters. Any individual who reports a fraud, waste and abuse concern has the ‘right’ to remain anonymous and Johns Hopkins HealthCare commits to enforcing this ‘right”!
How can I report fraud?
Reporting is simple! To contact the EHP Compliance Department:
JHHC Program and Payment Integrity
Attention: Special Investigations Unit
7231 Parkway Drive
Hanover, MD 21076