Reporting Provider or Member Waste, Abuse or Fraud

If you suspect a patient (a person who receives benefits) or a provider (e.g., doctor, dentist, counselor, etc) has committed waste, abuse or fraud, you have a responsibility and a right to report it.

You can report providers/ clients to Cenpatico at:
Cenpatico
Attn: Waste, Abuse and Fraud/Compliance Unit
504 Lavaca, Ste 850
Austin, TX 78701

Or call (866) 685-8664

To report waste, abuse or fraud, gather as much information as possible.

When reporting a provider (e.g., doctor, dentist, counselor, etc) provide the following:

• 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 is helpful;
• Type of provider (physician, physical therapist, pharmacist, etc);
• Names and phone numbers of other witnesses who can aide in the investigation;
• Dates of events; and
• Summary of what happened.

When reporting a client (a person who receives benefits) provide the following:

• The person’s name;
• The person’s date of birth, social security number, or case number if available;
• The city where the person resides; and
• Specific details about the waste, abuse or fraud.