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How to report fraud or abuse:

Report online

Complete our suspected fraud and abuse reporting form. You can also get in touch by clicking "Live Chat" in the bottom right-hand corner of your screen.

Report by phone


Report by mail

Write to us at:
Cardinal Innovations Healthcare
Attention: Program Integrity Unit
550 S. Caldwell St., Suite 1500
Charlotte, NC 28202

What is Medicaid fraud and abuse?

Medicaid fraud: any time a member or provider submits a false claim or deceives someone in order to obtain coverage and/or payment for services.
Medicaid abuse: any time a member or provider engages in activities that result in excessive cost.

Examples of Medicaid fraud and abuse

  • The use of a Medicaid ID card by someone other than the recipient
  • A provider bills for services that weren't provided
  • A provider performs and bills for services that aren't necessary
  • A provider's reported credentials aren't accurate
  • Accepting kickbacks for patient referrals

Getting the facts

For a prompt analysis, gather this information before you make a report:

  • Name of Medicaid recipient and Medicaid ID number
  • Name of healthcare provider
  • Date(s) of service
  • Amount of money Medicaid has approved and/or paid
  • Description of the acts that you suspect involve fraud or abuse

How can you help reduce Medicaid fraud and abuse?

  • DO review your bill to make sure charges and service dates are correct.
  • DO ask for a copy of everything you sign.
  • DON'T let anyone borrow or use your Medicaid card number.
  • DON'T ask your doctor or other provider for treatment or care that you don't need.
  • DON'T share your medical information or records with anyone except a doctor, clinic, hospital, or other provider.

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