Call the OIG Fraud Hotline if you suspect wrongdoing
Tips from the public to the OIG Fraud Hotline help ensure that Texas Medicaid funds are not lost to fraud. The hotline was established in 2011 to identify solid allegations of fraud, waste and abuse and pass those reports to OIG investigators.
The hotline manager and team of six specialists receive approximately 180-250 calls per day, totaling 26,603 calls answered in fiscal year 2020.
How it works
Health care providers, staff, patients and the public may call to report observations of other providers, suspicious corporate behavior or a Medicaid beneficiary who may be abusing benefits. The initial call to the hotline generally takes about five minutes, includes basic questions about the allegation and determines if a complaint needs further investigation.
If the complaint is Medicaid-related and contains sufficient provider-identifying information, a case is opened and assigned to an intake investigator. The investigator determines whether a complaint represents a violation of Medicaid policy or federal and state law or regulation.
Based on the findings of a preliminary investigation, a case may be closed; concluded with a recommendation for provider education; referred to another agency or entity; or referred for a full-scale investigation.
How to report
Callers are asked to provide contact information, which is used if an investigator has further questions. A caller may choose to remain anonymous, but there are incidents where a witness or first-hand account is helpful. To remain truly anonymous, you are encouraged to make the report online through ReportTexasFraud.com.
The OIG Fraud Hotline is answered from 8 a.m. to 5 p.m. Monday through Friday. You can report suspected benefits fraud or misuse by calling 800-436-6184 or use www.ReportTexasFraud.com.