Fraud, Waste and Abuse (FWA)

Fraud is lying with the knowledge that the lie could result in a benefit to someone. Waste and Abuse are practices that result in unnecessary cost to health programs, or payment for services that are not medically necessary. Health Plan of Nevada makes every effort to identify, prevent and investigate Fraud, Waste and Abuse (FWA). It is also your right and responsibility to inform us if you notice FWA. Please call our Health Care Fraud Tip Line at 1-866-242-7727 if you are aware of any of the following:

  • Falsifying claims/encounters.
  • Alteration of claim.
  • Double billing.
  • Billing for services not provided.
  • Denying access to services/benefits.
  • Failure to refer for needed services.
  • Member eligibility fraud.
  • Physical abuse.
  • Mental abuse.
  • Emotional abuse.
  • Neglect.
  • Failure to report third party liability.
  • Misrepresentation of medical condition.
  • And other types of fraud, waste or abuse.

You may also write to:

Health Plan of Nevada
P.O. Box 15645
Las Vegas, NV 89114-5645
Attn: Medicaid Compliance Officer, 2720-5