Neighborhood has an obligation and is committed to preventing, detecting and correcting incidents of fraud, waste and abuse. To protect the availability of health care services, we work to ensure the appropriate use of money for the Neighborhood INTEGRITY for Duals program. We want you to report suspected cases of fraud, waste and abuse. These are situations you think may not be right.
Fraud happens when a member or provider intentionally does something that is not honest so that they or another person experiences positive results or some type of benefit or incentive. Waste happens when there is an overutilization of services or other practices that, directly or indirectly, result in unnecessary costs to the health care system. Abuse happens when appropriate business and medical practices are not followed, and the result is an unnecessary cost to the Neighborhood INTEGRITY for Duals program.
Below are some examples of fraud, waste and abuse:
- Sharing, loaning, changing, or selling a Neighborhood INTEGRITY for Duals ID card so someone else can get health care services.
- Using someone else’s Neighborhood INTEGRITY for Duals ID card to get health care services.
- Using a provider’s prescription pad. Altering or forging a provider’s prescription to receive drugs.
- Having Rhode Island Medicaid and another state’s Medicaid at the same time.
- Lying about how much money you make or where you live to become eligible for benefits.
- Lying about services received under self-directed care.
- Selling or giving prescriptions to others that were prescribed to you.
- Providers or hospitals that bill you or Neighborhood for services that were never provided.
If you suspect fraud, waste, or abuse, please call Neighborhood’s anonymous Compliance Hotline at 1-888-579-1551.
Helpful Links
- Privacy and Security of Member Information
- Notice of Privacy Practices
- Member Protected Health Information and Privacy Forms
Questions?
Please call us at 1-844-812-6896 (TTY 711) 8:00 a.m. to 8:00 p.m., seven days a week from October 1 through March 31. From April 1 through September 30, you can call us 8:00 a.m. to 8:00 p.m. Monday through Friday. You may leave a voicemail on Saturdays, Sundays, and federal holidays. The call is free.
H7635_0725PYIWBLPFrdWstAbs_M Approved 10/30/2025
Last updated: October 2, 2025 at 2:00 p.m.