Fraud Prevention & Ethics

Health care fraud affects everyone — members, providers, employers, and the overall health care system. Fraud, waste, and abuse can increase costs, reduce access to services, and undermine trust.

CarewayUSA is committed to maintaining the highest standards of integrity, transparency, and ethical conduct across all our health and wellness membership programs.

Our Zero-Tolerance Approach

CarewayUSA maintains a zero-tolerance policy toward fraud, waste, and abuse. Any suspected activity is reviewed seriously and handled promptly in accordance with applicable laws and internal policies.

What Is Fraud, Waste, and Abuse?

Fraud

Fraud occurs when false, misleading, or inaccurate information is knowingly used to obtain benefits, services, or payments.

• Providing false or altered information
• Misrepresenting eligibility or coverage details
• Attempting to receive benefits not permitted under program terms

Waste

Waste occurs when services or benefits are used excessively or inefficiently, resulting in unnecessary costs.

• Requesting services beyond program guidelines
• Overuse of benefits without clear necessity

Abuse

Abuse involves practices that do not align with sound administrative or operational standards and may result in unnecessary costs or misuse.

• Improper use of membership benefits
• Failure to follow established program terms

How to Report a Concern

Language Assistance

CarewayUSA provides assistance services to help members understand their benefits and program information. Please contact our support team if you require assistance.

Legal Notice

CarewayUSA provides health and wellness membership programs. These programs are not insurance and are subject to specific terms, conditions, limitations, and exclusions.