Fraud, Waste, and Abuse

Superior HealthPlan (Superior) STAR+PLUS Medicare-Medicaid Plan (MMP) wants to find and stop fraud, waste and abuse. We want you to help us. We want our doctors to help us. Please tell us if you see something that you do not think is right.

What does this mean?

Fraud: Purposely lying or misleading to get money or goods of a healthcare benefit program (by means of false or fraudulent pretenses, representations, or promises).

Waste: Using services or other practices that result in costs not needed.

Abuse: Getting money for items or services when there is no legal reason for that payment, but without knowing and/or intentional misrepresentation of facts to obtain payments.

What can you do to help prevent, report and stop fraud, waste and abuse?

You can call Superior, the Federal or State Agencies to report and stop fraud, waste and abuse. Those numbers are listed below:

  • Texas Office of Inspector General (TX-OIG) Fraud Hotline: 1-800-436-6184
  • Texas Attorney General Medicaid Fraud Control Hotline: 1-800-252-8011
  • US Health & Human Services, Office of Inspector General (HHS-OIG): Hotline: 1-800-447-8477
  • Superior HealthPlan Fraud Hotline: 1-866-685-8664

You can also report any suspected fraud or abuse to by calling Superior Member Services at 1-866-896-1844. For more information, call Member Services at 1-866-896-1844. Hours are from 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on holidays, you may be asked to leave a message. Your call will be returned the next business day. TTY users call 711. 

All information will be kept private. Eliminating fraud, waste and abuse will provide more time and money for your healthcare needs.

Last Updated: 10/01/2016