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Fraud, Waste, and Abuse Prevention

UPMC Health Plan’s Special Investigations Unit (SIU) detects, prevents, and investigates suspected insurance fraud and abuse.

Intentional fraud, waste, and abuse victimizes UPMC Health Plan, its members, employees, providers, and business partners. It affects the entire insurance community.

Our commitment is to prosecute the perpetrators of both internal and external fraud against UPMC Health Plan. We will investigate all allegations of fraud, waste or abuse committed by providers, members, employees, and any other entity doing business with UPMC Health Plan.

The SIU is UPMC Health Plan's corporate ally against insurance fraud. There is no tolerance for fraud-related activity, and all fraudulent acts will be referred to the appropriate regulatory health care oversight or law enforcement agency. If you would like to report suspected fraud, waste, or abuse:

To report suspected fraud, waste, or abuse:
Call 1-866-FRAUD-01
If you have a suggestion, please contact:
Special Investigations Unit
TTY 711