Fraud, Waste and Abuse

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 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
1-844-843-0004

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