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South Country Health Alliance | Compliance: Fraud, Waste, and Abuse

Fraud, Waste, & Abuse

South Country is committed to identifying, preventing, correcting, and reporting fraud, waste, and abuse. The efforts undertaken as part of these processes are collaborative in nature and involve training and education, monitoring, audits including automated claims system checks, membership, and participation in the Minnesota Healthcare Fraud Taskforce, and more. All activities are consistent with applicable laws, regulations, and government health care program requirements.

It is the responsibility of all employees, governing board members, and first tier, downstream, and related entities (FDRs) to immediately report suspected fraud to the Compliance Department or by calling the Compliance Hotline. We also strongly encourage our member counties and participating providers to report any suspected fraud.

In accordance with established policies and procedures, South Country is authorized to investigate allegations of fraud concerned with all lines of business and involving providers, members, group representatives, employees, or other individuals or groups.

Links on this page provide information relating to Medicare training courses, fraud, waste, and abuse, the Deficit Reduction Act, and a link to the Compliance Hotline, Report It. More information on the annual training requirements for FDRs can be found in the FDR Compliance Guide.

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