Fraud, Waste and Abuse

The Department of Health Care Policy & Financing is committed to preventing, identifying, and combating fraud, waste and abuse in the Medical Assistance Program.

  • Fraud: an intentional act of deception, misrepresentation, or concealment in order to gain something of value.
  • Waste: over-utilization of services (not caused by criminally negligent actions) and the misuse of resources.
  • Abuse: excessive or improper use of services or actions that are inconsistent with acceptable business or medical practice.

Report Suspected Fraud, Waste, and Abuse

Compliance Programs

Provider Termination

Provider Self-Disclosure and Self-Audit