Do you want to report waste, abuse, or fraud?
Let us know if you think a doctor, dentist, pharmacist at a drug store, other health care providers, or a person getting benefits is doing something wrong. Doing something wrong could be waste, abuse or fraud, which is against the law. For example, tell us if you think someone is:
- Getting paid for services that weren’t given or necessary.
- Not telling the truth about a medical condition to get medical treatment.
- Letting someone else use their Medicaid ID.
- Using someone else’s Medicaid ID.
- Not telling the truth about the amount of money or resources he or she has to get benefits.
To report waste, abuse, or fraud, choose one of the following:
- Call the OIG Hotline at 800-436-6184
- Visit https://oig.hhsc.state.tx.us. Under the box labeled “I WANT TO”, click Report Waste, Abuse, or Fraud to complete the online form
- Report directly to your health plan:
Dell Children’s Health Plan Appeals
2505 N. Highway 360
Grande Prairie, TX 75050
Dell Children’s Health Plan Toll Free Phone Number: 888-596-0268 (TTY 711)
You may also visit the Texas Office of Consumer Credit Commissioner or the Office of Inspector General. If you prefer to talk to a person, call the Office of Inspector General (OIG) Fraud Hotline at 800-436-6184, or you may send a written statement to the following OIG addresses:
To report providers, use this address:
Office of Inspector General
Medicaid Provider Integrity/Mail Code 1361
P.O. Box 85200
Austin, TX 78708-5200
To report waste, abuse or fraud, gather as much information as possible.
When reporting about a provider (a doctor, dentist, counselor, etc.) include:
- Name, address, and phone number of provider
- Name and address of the facility (hospital, nursing home, home health agency, etc.)
- Medicaid number of the provider and facility, if you have it
- Type of provider (doctor, dentist, therapist, pharmacist, etc.)
- Names and phone numbers of other witnesses who can help in the investigation
- Dates of events
- Summary of what happened
When reporting about someone who gets benefits, include:
- The person’s name
- The person’s date of birth, Social Security Number, or case number if you have it
- The city where the person lives
- Specific details about the waste, abuse or fraud
If you think you have been treated unfairly or discriminated against, call the U.S. Department of Health and Human Services toll-free at 800-368-1019. You can also view this information online at www.hhs.gov/ocr.