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CHIP Fraud, Waste or Abuse

How do I report Fraud, Waste, or Abuse?

Let us know if you think a doctor, dentist, pharmacist at a drug store, other health-care provider, or a person getting CHIP benefits is doing something wrong. Doing something wrong could be waste, abuse or fraud, which is against the law. For example, tell us if you think someone is:

  • Getting paid for CHIP services that weren't given or necessary.
  • Not telling the truth about a medical condition to get medical treatment.
  • Letting someone else use a CHIP ID.
  • Using someone else's CHIP ID.
  • Not telling the truth about the amount of money or resources he or she has to get benefits.

To report fraud, waste, or abuse choose one of the following:

  • Call the OIG Hotline at 1-800-436-6184, or
  • Visit https://oig.hhsc.state.tx.us/ and go to "Click Here to Report Waste, Abuse, and Fraud" to complete the online form;

Or you can report directly to us at:

Cook Children's Health Plan
Attention: Compliance
P.O. Box 2488
Fort Worth, TX 76113-2488
1-800-964-2247

To report fraud, waste, or abuse gather as much information as possible. When reporting about a provider (a doctor, dentist, counselor, etc.) include:

  • Name, address, and phone number of provider
  • Name and address of the facility (hospital, nursing home, home health agency, etc)
  • Medicaid number of the provider and facility, if you have it
  • Type of provider (doctor, dentist, therapist, pharmacist, etc.)
  • Names and phone numbers of other witnesses who can help in the investigation
  • Dates of events
  • Summary of what happened
  • When reporting about someone who gets benefits, include:
  • The person's name
  • The person's date of birth, Social Security Number, or case number if you have it
  • The city where the person lives
  • Specific details about the waste, abuse or fraud.