Medicaid Fraud / Elder Abuse Complaint

Medicaid Fraud / Elder Abuse Complaint
This form is to report Medicaid Fraud; or Elder Abuse, Neglect or Financial Exploitation. If you have any questions or require assistance filling out this form, please call the Medicaid Fraud Hotline at 1-907-269-6279.
Does your complaint involve allegations of fraud committed by a Medicaid recipient (beneficiary)?
The Medicaid Fraud Control Unit investigates allegations of fraud by providers of Medicaid eligible services. The Medicaid Fraud Control Unit cannot investigate allegations of fraud committed by a Medicaid recipient (beneficiary). If the fraud involves a Medicaid recipient (beneficiary), it needs to be reported to the Department of Public Assistance.

The Department of Health's Fraud Control Unit is responsible for investigating welfare fraud. When complaints are received, they look into cases where people applying for or receiving benefits—such as Alaska Temporary Assistance, Food Stamps, Medicaid, and Adult Public Assistance—might be providing false information.
- Submit a Fraud Allegation Report

Your Information
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Email
example@example.com
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Alternative Phone
Please enter a valid phone number.Format: (000) 000-0000.
Incident Information
Victim's Name

First NameLast Name
Victim's Phone
Please enter a valid phone number.Format: (000) 000-0000.
Suspect/Provider's Name

First NameLast Name
Suspect/Provider's Phone
Please enter a valid phone number.Format: (000) 000-0000.
Witness's Name

First NameLast Name
Witness's Phone
Please enter a valid phone number.Format: (000) 000-0000.
Incident Description:
Any identifiable health information you include above is not protected by the Health Insurance Portability and Accountability Act (HIPAA).
Facility / Business Entity Information
Facility / Business Entity Name
Facility / Business Entity Address

Street Address

Street Address Line 2

CityState

Zip Code
Facility / Business Entity Phone
Please enter a valid phone number.Format: (000) 000-0000.
Facility / Business Entity Website
Name and case numbers of other agencies contacted:
Please verify that you are human
Should be Empty:

Your Information