Fraud, Waste, and Abuse

Central Florida Cares Health System, Inc. (CFCHS) promotes a culture of integrity and works with business partners, subcontractors, and employees to ensure compliance with standards of ethical practice and regulatory requirements. CFCHS investigates all allegations of Fraud, Waste and Abuse (FWA), takes corrective action of any supported allegations, and reports confirmed misconduct to the pertinent government entities.

If you suspect Fraud, Waste and Abuse, please take into consideration the following definitions:

Fraud: Any intentional deception or misrepresentation made by an entity or person with the knowledge that the deception could result in an unauthorized benefit for payment to the entity, him/herself or another person.

Waste: Refers to the irresponsible and careless expenditure, consumption, mismanagement, use, or squandering of healthcare resources, including incurring costs because of inefficient or ineffective practices systems or controls.

Abuse: Refers to practices that are inconsistent with sound fiscal, business, or medical practices, and result in an unnecessary cost, or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards of care. It also includes client practices that result in unnecessary cost.

Some FWA instances may involve:

  • Contract Fraud and Mismanagement
  • Conflict of Interest
  • Misuse of Position or Property
  • Improper use of Public Funds
  • Violations of Law, Rule, or Procedure
  • Inappropriate Acts and/or Omission that results in client injury, abuse, neglect or death

To report suspected FWA or any other Compliance issue you may use either of the following methods:

 

  • You can also contact the Office of the Florida Inspector General at:

IG.Complaints@myflfamilies.com

http://www.dcf.state.fl.us/admin/ig/rptfraud1.shtml

1317 Winewood Blvd., Bldg. 5, Second Floor

Tallahassee, FL 32399-0700

Phone: (850) 488-1225

Fax: (850) 488-1428