Fraud & Abuse

MetroPlusHealth is dedicated to helping prevent health care fraud and investigates all allegations of fraud, waste or abuse. Fraud includes member fraud, provider fraud, employee fraud and vendor fraud.

Examples of fraud include:

• Billing for services that were not rendered
• Billing for office visits that you did not go to
• Submitting multiple bills for the same date of service
• Offering money or goods to use a member identification card
• Sharing of member identification cards
• Providing false information in order to obtain insurance coverage

If you suspect fraud you may contact MetroPlusHealth confidentially in the following ways:

• Call: 1-888-245-7247 (In reporting via the hotline you are able to remain anonymous)
• Write:
  MetroPlus Health Plan Special Investigation Unit
  50 Water Street, 7th Floor
  ​New York, NY 10004
• E-Mail: Compliance Department at [email protected]

MetroPlus Health Plan members can always call us 24/7 at 1-800-303-9626 for customer service questions and concerns. Or, for self-service, members may register on our new member website here where they can change their contact information, view their claims, access their member rewards, refill prescriptions, print or order a new ID card, and much more.