Fraud, Waste, + Abuse

Fraud, Waste, + Abuse

See something? Say something.

We encourage you to report incidents of suspected fraud, waste, or abuse. Health Share reports all verified cases of fraud to the Medicaid Fraud Control Unit (MCFU).

Here’s how you can report:

  • Call the anonymous Health Share Compliance Hotline at 503-416-1459. 
  • Call the State of Oregon Department of Human Services (DHS) Fraud Hotline: 888-372-8301. 
  • Complete and return the Fraud, Waste, and Abuse reporting form.
    • You can fax the form to us at 503-459-5749 or mail it to us at:
      Compliance Officer
      Health Share of Oregon
      2121 SW Broadway, Suite 200
      Portland, OR 97201

Download the Health Share of Oregon Guide to Reporting Fraud, Waste, and Abuse to learn more.

What is Fraud?

Fraud is an intentional deception or misrepresentation, whether by act or omission, made by a person with the knowledge that the deception could result in some unauthorized benefit to himself/herself or some other person.

What is Waste?

Waste is health care spending that can be eliminated without reducing quality of care. It includes inefficient use or management of resources, unnecessary expenses, or procedures that cannot reasonably be expected to yield better outcomes.

Examples of Fraud

  • Billing for services not provided (phantom billing)
  • Accepting money for referrals (kickbacks)
  • Billing for unnecessary services or tests
  • Billing twice for the same services
  • Dispensing generic drugs and billing for brandname drugs
  • Billing for lengthy services that only take a short period of time