Healthcare fraud is an expensive crime. Between 3 percent and 10 percent of total healthcare spending – up to $224 billion – is lost to fraud each year, according to The National Health Care Anti-Fraud Association. We all pay for it through higher healthcare costs, insurance premiums and taxes.
Express Scripts has a team of experts dedicated to identifying and investigating suspected fraud, waste and abuse. You play an integral role in helping us do that. Report suspicious activity to Express Scripts.
Some examples of fraud, waste and abuse that should be reported are:
- Apparent alterations or forgeries of prescriptions
- Any claims appearing on a member's profile for services not rendered
- Suspected theft of a member's identity or membership card
- Prescriptions that cannot be verified with the prescribing physician
- Frequent requests for "refill too soon" or "quantity limit" overrides
- Doctor or pharmacy "shopping" – visiting multiple doctors or pharmacies to obtain various prescriptions
You have the right to remain anonymous. However, providing your name and contact info will allow us to contact you for further information if needed. All information provided will be kept strictly confidential.
If you suspect fraud, waste or abuse: Call the Express Scripts Fraud Tip Hotline at 866.216.7096.