The following statement is from the Centers for Medicare and Medicaid Services (CMS) in regard to fraud, waste, and abuse.
The Medicare prescription drug benefit was implemented by the Centers for Medicare and Medicaid Services (CMS) to allow all Medicare beneficiaries access to prescription drug coverage beginning on January 1, 2006.
Delmarva Foundation (this work is performed through Health Integrity, LLC, a wholly owned subsidiary) is responsible for monitoring for fraud, waste, or abuse in the Medicare prescription drug benefit.
Health Integrity, LLC, is authorized by CMS to monitor the prescription drug program and to investigate any beneficiary complaints related to fraud, waste, and abuse in the Medicare prescription drug benefit.
Health Integrity, LLC, is interested in receiving reports of potential fraud, waste, or abuse from Medicare beneficiaries. Examples of these complaints include:
- An individual or organization pretending to represent Medicare and/or Social Security asks you for your Medicare or Social Security number, bank account number, credit card number, money, etc.
- Someone asks you to sell your Medicare prescription drug card.
- You feel a Medicare prescription drug plan has discriminated against you, including not allowing you to sign up for their plan because of your age, health, race, religion, or income.
- You are encouraged to disenroll from your plan.
- You are offered cash to sign up for a Medicare prescription drug plan.
- You are offered a gift worth more than $15 to sign up for a Medicare prescription drug plan.
- Your pharmacy does not give you all of your drugs and has no plans to provide the drugs to you for your prescription at a later time.
- You are billed for drugs that you do not receive.
- You believe that you are charged more than once for your premium costs.
- Your Medicare prescription drug plan does not pay for your covered drugs.
- You receive a different drug than your doctor ordered and your doctor did not allow substitution.
Please contact us at 1-877-7SafeRx (1-877-772-3379) to report complaints about one of these types of fraud, waste, or abuse issues, or a related complaint. Our fax number is 1-410-819-8698, and our website is www.healthintegrity.org.
If you have a general question or concern related to your Medicare drug benefit and it is not a potential fraud, waste, or abuse issue, please contact your TEAMStar Medicare Part D (PDP) plan at 1-866-524-4173 (TTY/TDD users: 711), or call 1-800-MEDICARE (1-800-633-4227) (TTY/TDD users: 1-877-486-2048).
Health Integrity, LLC