Fraud and abuse

Here are a few examples of potential fraud and abuse: 

"Fraud is when a person knowingly makes or permits another person to make a false statement. Examples of Fraud include Members submitting false or misleading information on a membership application form, making a false request for reimbursement, failing to notify Tufts Health Plan of changes (such as residency) that affect the Member's eligibility or lending their Tufts Health One Care Member ID Card to another person so s/he can get Health Care or pharmacy Service." 

To report potential health care fraud and abuse or if you have questions, please call us at 1-855-393-3154 (TTY: 711), Monday through Friday, from 8 a.m. to 8 p.m., or email [email protected]. You do not need to provide your name or member information. You can also call our toll-free confidential hotline anytime at 1-877-824-7123 or send an anonymous letter to us at: 

Tufts Health Plan 
Attn: Fraud and Abuse 
P.O. Box 524 
Canton, MA 02021-1166 

You also can reach out to the state. 

• Call the Medicaid Fraud Tip line at 1-617-963-2360
• File a complaint online at mass.gov/how-to/file-a-medicaid-fraud-complaint 
• Or send a letter to: 

Medicaid Fraud Control Unit 
Office of the Attorney General 
One Ashburton Place 
Boston, MA 02108 

H7419_4520_CMS Approved 
Page modified on: 4/7/2016 6:56:54 PM