OIG reports fraud hotline results

The OIG Fraud Hotline handled 6,657 calls and other points of contact in the third quarter of fiscal year 2022. The hotline is an avenue for the public to report suspicious behavior involving a health care provider or client who may be abusing Medicaid benefits.

When calling the hotline, you will be asked basic questions about the allegation to determine if a complaint needs further investigation. If the complaint contains enough information, a case is opened and assigned to an investigator. The investigator determines whether a complaint represents a violation of Texas Health and Human Services policy or federal/state law or regulation. Based on the findings of a preliminary investigation, a case may be closed; concluded with a recommendation for education; referred to another agency or entity; or referred for a full-scale investigation.

In the third quarter, hotline staff referred 1,672 reports from the more than 6,500 allegations for further investigation or action to the appropriate OIG division. Here is a breakdown of the types of referrals made by the hotline during the third quarter:

You can report suspected benefits fraud or misuse by calling 800-436-6184 or visiting ReportTexasFraud.com.