Attention! Nationwide recall of certain apple sauce pouches due to possible contamination with lead. Learn more.

Attention! There was a recent cyber-attack that involved Change Healthcare. If you are a provider that uses Change Healthcare, click here to learn more.

Fraud and Compliance Concerns

What is fraud?

Fraud is a serious matter. 

Fraud is illegal. It is not telling the truth so you can get the money that you do not deserve.

An example of fraud for enrollees is: 

  • Claiming that you live in D.C., but you do not. 

An example of fraud for providers is: 

  • Billing for services and supplies that were not provided.

Please let us know if you suspect fraud. HSCSN Grievance, Appeals, and Compliance Hotline is a confidential service.

You can do this anonymously.

Concerns may be reported directly to:

  • HSCSN Grievance, Appeals and Compliance Hotline at 1 (844) 556-9152
  • HSCSN Compliance Director at (202) 495-7718
  • The D.C. Department of Health Care Finance’s Fraud Hotline at 1 (877) 632-2873

Compliance

HSCSN is committed to:

  • Following the law

  • Honesty, integrity, and high ethical standards in the conduct of its business.

  • Investigating your concerns and resolving them quickly. 

Anyone can report a concern about the HSCSN Code of Conduct. 

 

What should be reported to the Compliance Department?

  • Violations of HSCSN’s Policies & Ethics
  • Fraud, Waste, and Abuse
  • Code of Conduct Violations
  • Conflict of Interest
  • Privacy & HIPAA Issues

For More Information or to Report a Complaint

Please let us know if you suspect a violation of conduct. It is not required for you to identify yourself or give your name. You will not be punished for filing a complaint.  

To file a complaint with the Secretary of the Department of Health and Human Services:

  • Send a letter to 200 Independence Avenue, SW, Washington, D.C. 20201
  • Call 1(877) 696-6775

To file a complaint with our office:

  • Call the HSCSN Compliance & Privacy Officer at (202) 495-7718
  • Mail a letter to the HSCSN office at 1101 Vermont Avenue NW, Suite 1200, Washington, D.C. 20005