Report Fraud, Waste and Abuse
f you suspect a provider, member or CPHL staff person (s) is engaged in any fraud/ abuse or questionable activity, you can anonymously report it by calling 855-699-5046 or by clicking on www.centersplan.ethicspoint.com
You can also report it to the NYS Medicaid Office of Inspector General’s office at:
Email: bmfa@omig.ny.gov
Toll-free: 1-877-87FRAUD (877-873-7283)
Telephone: (518) 402-1378
Fax: (518) 408-0480
Internet: www.omig.ny.gov
Or By Mail: NYS OMIG – Bureau of Medicaid Fraud Allegations 800 North Pearl Street Albany, NY 1220
Chief Compliance Officer Lois Faust
Email Lfaust@centersplan.com
Phone (718) 215-7000 Ext. 3104
Anonymous Hot-Line Number 1-855-699-5046
Email compliance@centersplan.com
For more information about Fraud and Abuse, please click here
Self-Disclosure of Overpayment by Providers
In accordance with 18 NYCRR Part 521-2.4 (h) & 3.3(b), providers must report, return, and explain any overpayments to Centers Plan for Healthy Living, LLC (CPHL) within sixty (60) days of identification. Any provider who has received overpayments, related to Medical Assistance Programs such as Medicaid, has an obligation to report the overpayment to CPHL.
Overpayment is the amount paid by a Medicaid agency to a provider more than the amount that is allowable for furnished payments. Providers must exercise reasonable diligence to determine if an overpayment has occurred and report it to CPHL.
Providers can report overpayments to the email address provided below:
CPHL will review all reported overpayments, and follow up with the provider for potential next steps.
For further information regarding self-disclosure of overpayments, please refer to the OMIG webpage below:
Last modified: Apr 10, 2024