It has been estimated that over 60 billion dollars a year is spent on health care fraud. Johns Hopkins US Family Health Plan (USFHP) wants to find and stop health care fraud. Fraud is any dishonest act that results in a benefit to the person doing the act or someone else that he or she is not entitled to. Some examples of health care fraud are:

  • Using someone else’s USFHP insurance card to get health care services.
  • Loaning your USFHP insurance card to another person so they can receive health care services.
  • Selling or diverting prescription medicine or items provided to you under the Johns Hopkins US Family Health Plan.
  • Obtaining multiple prescriptions for the same drug from several doctors during the same time period.
  • Forging or changing prescription forms.
  • Receiving bills for equipment or services you never received.

The Compliance Department at Johns Hopkins US Family Health Plan investigates all charges of actual or suspected health care fraud.

How Can I Help?

You can help reduce health care fraud by following these simple rules:

  • Never loan your USFHP insurance card to anyone;
  • Report all suspicions of fraud; and
  • Report lost or stolen insurance cards to the USFHP Customer Service Department at 800-808-7347 or 410-424-4528.

Remember health care fraud affects everyone. If you believe someone is committing fraud against Johns Hopkins US Family Health Plan, please report the act to the USFHP Compliance Department. You can remain nameless, and all reports are kept confidential. Johns Hopkins Health Plans is committed to following all applicable laws and regulations, in particular those that address health care fraud, waste and abuse and the improper billing of health care services.

What happens to me if I report a concern?

Johns Hopkins Health Plans takes its responsibility to protect your ‘right to report’ seriously! No Johns Hopkins Health Plans employee may threaten, coerce, harass, retaliate, or discriminate against any individual who reports a compliance concern. To support this effort, the Health Plan has enacted zero-tolerance policies and annually trains all personnel on their obligation to maintain the highest integrity when handling compliance-related matters. Any individual who reports a compliance concern has the ‘right’ to remain nameless and Johns Hopkins Health Plans commits to enforcing this ‘right”!

How can I report fraud?

Reporting is simple! To contact the USFHP FWA Department:
Call: 410-424-4971
Write: Johns Hopkins Health Plans, Payment Integrity, Attn: FWA Department, 7231 Parkway Drive, Hanover, MD 21076