Fraud and Abuse

Fraud is when you knowingly deceive someone else.  It can also be when you misrepresent yourself.  This then results in some benefit to you or some other person that is not allowed.  Some types of fraud may include:

  • A doctor billing the Upper Peninsula Health Plan (UPHP) for services that you did not get.
  • Someone else using your mihealth or UPHP card.
  • Changing a prescription.
  • Giving false facts about you or someone else.
  • Not telling providers you have other insurance.

Abuse is any action that results in unneeded costs to UPHP.  Either a provider or a member can take this action.  Some types of abuse are:

  • Going to the emergency room if there is no emergency.
  • Threatening or abuse behavior (by phone, in writing, or in person).

You may report possible fraud and abuse to:

UPHP Customer Service
853 West Washington Street
Marquette, MI 49855
1-800-835-2556

Michigan Department of Health and Human Services
Office of Inspector General
PO Box 30062
Lansing, MI 48909
Call Toll-Free at 855-MI-FRAUD (643-7283)

MDHHS Office of Inspector General online complaint form


Page Last Updated: 05/8/2017