Report Fraud, Waste, and Abuse
The Office of Inspector General (OIG) investigates reports of suspected fraud, waste, and abuse of AHCCCS programs. Each year, OIG recovers and saves tens of millions of dollars in fraudulent claims against Medicaid.
The primary way AHCCCS discovers fraud is through reports from people like you who report it to us.
What does fraud look like?
Fraud is when someone lies or gives false information with the intent to receive benefits or payments for which they are not legally eligible. Fraud can be committed in a variety of ways. Here are just a few:
Members:
- Providing Incorrect Household Composition Information
- Falsifying Income and Not Reporting Income
- Hiding Employment or Self-Employment Information
- Falsifying Arizona or US Residency Status
- Unreported other insurance
- Misrepresenting medical condition/s or ethnicities
Providers:
- Performing and/or billing medically unnecessary services
- Making False Statements and False Claims
- Billing for Services and Supplies Not Provided
- Double Billing, Over Billing, and Incorrect Coding
- Committing Prescription and Pharmacy Fraud
- Paying for and/or receiving kickbacks
Who Can Report Fraud or Abuse
Absolutely anyone can report fraud, abuse, or member abuse. There are no restrictions and you may remain anonymous. OIG depends on employees, members, providers and the general public to report any suspicious fraud or abuse.
Report Provider Fraud
If you want to report suspected fraud by medical provider, please call the number below:
- In Arizona: 602-417-4045
- Toll Free Outside of Arizona Only: 888-ITS-NOT-OK or 888-487-6686
Report Member Fraud
If you want to report suspected fraud by an AHCCCS member, please call the number below:
- In Arizona: 602-417-4193
- Toll Free Outside of Arizona Only: 888-ITS-NOT-OK or 888-487-6686
Questions
Contact the AHCCCS Office of Inspector General with questions about fraud, waste or abuse of the program, or abuse of a member at AHCCCSFraud@azahcccs.gov.