Reporting Fraud, Waste and Abuse

California Health & Wellness is serious about finding and reporting times that California Medicaid funds are used in the wrong way. This is called waste, fraud or abuse.

To report waste, abuse, or fraud, provide as much information as possible. This will make it easier to investigate.

When reporting about a provider (a doctor, dentist, counselor, etc.) it's helpful to, but not required, to include all of the following:

  • Name, address, and phone number of provider
  • Name and address of the facility (hospital, nursing home, home health agency, etc.)
  • Medi-Cal 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, or case number if you have it
  • The city where the person lives
  • Specific details about the waste, abuse, or fraud