Recognizing fraud, waste and abuse and
Protect your identity by knowing the signs of fraudulent schemes and questionable offers involving Medicare. An identity thief might try to use your Medicare information to get paid for care you never received.
- Look out for people asking for your Medicare claim number or other plan information, or who offer bribes if you will see an unfamiliar doctor or use services you don’t need.
- Examples of fraud include:
- Altering claims to obtain higher payments
- Soliciting, offering or receiving a kickback, bribe or rebate
- Using another person’s Medicare card to obtain care
- This is an example of abuse:
- A provider prescribing prescriptions that aren’t medically necessary.
- Sharp Health Plan will not contact you by phone to offer free diabetic or medical supplies. Unfortunately, scammers may sometimes offer free supplies in order to ask for your birth date, insurance ID, Medicare number or other personal information.
If you get a call like this one, do not provide any information.
Please report your concerns using the information below.
If you suspect fraud, abuse or waste, contact us immediately. Call our Regulatory Affairs Department at 1-858-499-8237 (TTY/TDD: 711). Or, send a letter to:
Sharp Direct Advantage
Fraud and Abuse Investigations
8520 Tech Way Suite 201
San Diego CA 92123
You can help us stop health care fraud.
You do not have to give your name. Just tell us why you think fraud is occurring. Give us the name of the provider or member, and tell us what you are worried about. We take your questions and input seriously. Every effort will be made to protect your
identity. There will be no retaliation for good faith reporting.
Additional contact information for reporting fraud
You may also contact Medicare directly with concerns about Medicare Advantage plans or Medicare Prescription Drug Plans.