How do I report suspected fraud or misuse of state resources (general public)?
What is fraud?
Fraud is a deliberate deception or misrepresentation made by a person with knowledge that the deception could result in the gain of some unauthorized benefit to one's self or another person, and includes any act that constitutes fraud under applicable federal or state laws.
Examples of fraud may include:
- giving someone a generic drug and billing for the name-brand version of the medication;
- billing a person for services already paid for by a third party;
- misusing an individual's personal funds;
- falsifying documentation that authorizes services or increases the reimbursement rate paid for a service;
- signing the name of another person, creating identities, or otherwise using false names to provide and bill for services; and
- using billing procedures that result in claim submissions for services that are not provided nor supported by documentation.
Who can report fraud?
Anyone can report fraud, waste or abuse. The Texas Department of Aging and Disability Services (DADS) is required by law to refer suspected provider fraud to the Texas Health and Human Services Commission Office of Inspector General (OIG).
How can I report suspected fraud within a Texas health and human services agency?
Call 1-800-436-6184 to speak with the HHSC Office of the Inspector General. You can click here to contact them online. The OIG investigates and works to reduce waste, abuse and fraud within Texas health and human services agencies.
How can I report misuse or illegal acts involving state resources?
The Texas State Auditor’s Office (SAO) investigates allegations of misuse or illegal acts involving state resources.
To report fraud, waste or abuse occurring at a Texas state agency, college or university, call the SAO Hotline at 1-800-TX-AUDIT (892-8348). A form to report fraud, waste, or abuse is available on the SAO's Fraud Reporting page. Reports of fraud, waste or abuse may also be mailed to:
State Auditor's Office
P.O. Box 12067
Austin, TX 78711-2067.
How can I report suspected Medicare fraud?
Call 1-800-HHS-TIPS (1-800-447-8477) to report Medicare fraud. Click here to contact Medicare on-line.
Updated: April 3, 2014