Program Integrity – Fraud, Waste, and Abuse Compliance

Community Care’s Program Integrity – Fraud, Waste, and Abuse (FWA) Compliance Program reflects the regulations, recommendations, standards, and guidance of various payer, regulatory, and law enforcement programs. Our Special Investigations Unit (SIU) uses various tools to comply with these legal and ethical responsibilities and include activities such as establishing policy & procedure, monitoring claims, conducting audits, and providing education on various program integrity topics. We hope that Community Care staff, our primary contracts, and providers across the network find the following resources helpful as we work together to detect, deter, and prevent FWA in HealthChoices behavioral health care.

Telehealth Documentation Requirements Guide

FWA Provider Manual

Fraud, Waste, and Abuse Program Integrity: A Manual for Providers

FWA Newsletter


January 2023

January 2022

January 2021

February 2023

February 2022

February 2021

March 2023

March 2022

March 2021

April 2023

April 2022

April 2021

May 2023

May 2022

May 2021

June 2023

June 2022

June 2021

July 2023

July 2022

July 2021

August 2023

August 2022

August 2021

September 2023

September 2022

September 2021

October 2023

October 2022

October 2021

November 2023

November 2022

November 2021

December 2023

December 2022

December 2021

Policies and Procedures

Fraud, Waste, and Abuse Hotline

Community Care offers a telephone and email FWA hotline. Employees, providers, members administrators, vendors, and concerned others are encouraged to report suspected fraud, waste, or abuse in the HealthChoices behavioral health care (Medical Assistance) program. Telephone callers may leave a voicemail message including their name and telephone number where they can be reached along with details surrounding their concern. Reports can indicate if they wish to remain anonymous.

FWA telephone hotline: 1-866-445-5190

FWA email hotline: