How to Report Medi-Cal Fraud
- 1). Write, call or e-mail a Medi-Cal fraud complaint. Direct written complaints and phone calls to the Department of Health Care Services in Sacramento. The Attorney General of California also handles Medi-Cal complaints and has a bureau assigned to this specific function. Complaints of Medi-Cal fraud to public agencies are for law enforcement purposes and will not result in resolving private concerns about such fraud. If Medi-Cal fraud is affecting you personally, in addition to filing a public complaint, you may want to consult an attorney.
- 2). Provide your complete contact information when filing a complaint. While you have the right to remain anonymous, a fraud investigator may want to contact you if he has questions about your complaint. In addition to including your name, address, phone number and email address, indicate your preferred method of contact.
Likewise, provide complete contact information about the person or entity named in the complaint. If you only know the individual or medical provider's name, attempt to research, at a minimum, the city in which he or she resides. - 3). Indicate whether you contacted any law enforcement agency, federal or state, to report the suspected Medi-Cal fraud. California's Department of Health Care Services coordinates its anti-fraud efforts with federal agencies such as the Department of Justice and the Federal Bureau of Investigation as well as district attorneys offices statewide in order to prosecute Medi-Cal fraud cases. If you have contacted an attorney, you should also explain any related legal developments.
- 4). Provide a detailed description of the fraud you believe to have occurred. For example, if you were in a medical officer providers office and overheard the staff discussing charging a patient for an unperformed service, include the date and time of the office visit, the staff members present, the procedure discussed, the patient involved (if you heard the name) and any other descriptive information that could paint a picture of the scene for an investigator.
- 5). State whether you are willing to sign a sworn statement, under the penalty of perjury, stating the facts of the Medi-Cal fraud as you believe them. Be aware that if you agree to sign a sworn statement, you may become a witness for the prosecution in a criminal case brought against the offender.
