Preventing Heath Care Fraud

Health Care Fraud is rising higher and higher every year. Examples of Health Care Fraud include: billing for services not provided, using someone else’s Identity (ID) to obtain benefits or receive payment.

Prevention Tips

Here are a few helpful tips on how you can help prevent Health Care Fraud:

  • Do not give your Medi-Cal/Care1st card number to anyone except your doctor, clinic, hospital or other health care provider
  • Do not let anyone borrow your Medi-Cal/Care1st card
  • Never loan your Social Security card to anyone
  • Never sign a blank insurance claim form
  • Be suspicious of anyone who offers you a free medical screening in exchange for your Medi-Cal/Care1st card number
  • If it sounds too good to be true, it probably is. Be careful about accepting medical services when you are told they will be free of charge

Reporting Fraud

By working together we can make a difference. If you suspect Fraud report it today, call the Toll Free number of the Department of Health Services Anti-Fraud Line: 1-800-822-6222.


Doing the Right Thing, First Thing

The Care1st Corporate Compliance Department is responsible for the organization's compliance and ethical conduct in all matters.

Our Responsibilities

  • Proactive prevention of fraud and abuse and other illegal activities through education and training of healthcare employees, providers and members.
  • The Corporate Compliance Department is also instrumental in the enforcement of policies and procedures, and in generating an environment where the prevailing goal is "to always do the right thing and to do it the right way."

Compliance Hotline: 1-877-837-6057

If you suspect compliance, ethics or integrity violation, or have questions about specific practices, call Care1st’s Compliance Office, or send an e-mail to ComplianceDepartment@care1st.com.

Healthcare Fraud and Abuse

The Providers Guide to Detect and Report Fraud

We've made available a guide that deals with common fraud schemes in managed care and explains solutions and practices for all providers to implement. View Guide

HIPAA Privacy Practices