TELUS Health Anti-fraud, Waste and Abuse Program
Fraud, waste and abuse involving health plans is a serious issue in California and TELUS Health has established an anti-fraud, waste and abuse program to prevent, detect and correct fraud, waste and abuse. The program is also designed to protect participants in the delivery of employee assistance services through the timely detection, investigation, and prosecution of suspected fraud, waste and abuse in accordance with state and federal laws.
What is Fraud, Waste and Abuse?
Health care fraud is a criminal act of knowingly and intentionally submitting, or causing someone else to submit, false or misleading information to obtain money or any other health care benefit. Health care waste is overutilization of services or other practices that, directly or indirectly, result in unnecessary costs to the healthcare system. It is not generally considered to be caused by criminally negligent actions, but by the misuse of resources. Health care abuse is a similar activity or behavior that involves payment for items or services when there isn’t a legal right to that payment. Abuse does not require that the person have intent or knowledge.
Reporting Suspected Fraud and Abuse
You can report suspected fraud, waste or abuse to the TELUS Health Anti-fraud committee using any of the following methods:
You may remain anonymous when reporting fraud, waste or abuse. All information received by TELUS Health will be treated as confidential, and the results of investigations will be discussed only with persons having a legitimate reason to receive such information.
Thank you for your diligence in reporting potential fraud, waste and abuse.