CHIP Fraud, Waste or Abuse
How do I report Fraud, Waste, or Abuse?
Let us know if you think a doctor, dentist, pharmacist at a drug store, other health-care provider, or a person getting CHIP 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 CHIP services that weren't given or necessary.
- Not telling the truth about a medical condition to get medical treatment.
- Letting someone else use a CHIP ID.
- Using someone else's CHIP ID.
- Not telling the truth about the amount of money or resources he or she has to get benefits.
To report fraud, waste or abuse, choose one of the following:
- Call the OIG Hotline at 1-800-436-6184
- Visit https://oig.hhsc.state.tx.us/, click the blue box labeled “Continue to IG’s Fraud Reporting Form” and follow the steps to fill out the online complaint form; or
- Reach out to:
Cook Children's Health Plan
Att: Fraud, Waste, and Abuse
P.O. Box 2488
Fort Worth, TX 76113-2488
To report fraud, waste, or abuse 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.
Member Services is available Monday - Friday from 8am-5pm at 1-800-964-2247.