Report Fraud, Waste, and Abuse

Make a report if you suspect that someone is committing Medicaid/CHIP fraud. Some examples of fraud include (not limited to):

  • A person does not report all income or other health insurance when they apply for Medicaid/CHIP.

  • A person uses another member's card with or without the member's permission.

  • A doctor or a clinic bills for services that were not provided or were not medically necessary.

You can report suspected fraud and abuse in any of the following ways:

  • Call the Idaho Department of Health and Welfare at 1-208-334-5754 or email prvfraud@dhw.idaho.gov.

  • Complete a Provider Fraud Reporting Form at https://healthandwelfare.idaho.gov/. Scroll to the bottom of the home page and click on "Report Fraud." Next, click on "Report Healthcare Fraud".

  • Call the MCNA Fraud Hotline at 1-855-392-6262.

You can find more information about Fraud, Waste, and Abuse in your Member Handbook.