Reporting Medicaid Fraud and Abuse
Contact the N.C. Department of Justice's Medicaid Investigations Unit:
Medicaid Investigations Unit
Suite 200, 3824 Barrett Drive
Raleigh, N. C. 27609
Telephone: 919-881-2320
Fax: 919-571-4837
Medicaid recipient fraud, including fraudulent eligibility and transfer of assets, should not be reported to the Medicaid Investigations Unit, but instead should be reported to your local county’s Department of Social Services or to the N.C. Division of Medical Assistance at 919-733-7160.
You can also report certain types of fraud and abuse to the following agencies:
| Type of Fraud/Abuse | Agency | Telephone # |
| Medicaid Fraud | N. C. Division of Medical Assistance | 800-662-7030 |
| Nursing Homes/Facilities | N.C. Division of Facility Services | 800-624-3004 |
| Nurse Aide Misconduct | Health Care Personnel Registry | 919-733-8500 |
| Medicare Fraud | Office of Inspector General | 800-447-8477 |
| Tricare Fraud | Defense Criminal Investigative Service | 800-424-9098 |
| Health Care Fraud | Federal Bureau of Investigation | 704-377-9200 |
| Private Insurance Fraud | N.C. Department of Insurance | 800-546-5664 |
| Recipient Fraud | Your County Department of Social Services | |
| Recipient Eligibility/Transfer of Assets | N. C. Division of Medical Assistance | 919-733-7160 |
Who do I report?
Report the Medicaid provider(s) who you suspect have committed fraud or abuse. A Medicaid provider includes any individual, corporation, or other entity paid by Medicaid for providing a health care service. It also includes their officers and employees. Medicaid providers can include ambulance and transportation companies, chiropractors, community care service providers, dentists, home health agencies, hospitals, laboratories, medical equipment companies, nurses, nurse aides, nursing homes, adult care homes, pharmacies, physicians, physical therapists, podiatrists, and speech therapists.
Why report Medicaid fraud and abuse?
Patient abuse and the embezzlement, theft, and commingling of Medicaid funds should be reported because it exploits our most vulnerable elderly adults. Medicaid fraud should be reported because Medicaid payments are made from federal, state, and county funds. When Medicaid funds are lost or stolen through fraud, that money is no longer available to help deserving patients. Medicaid fraud cheats both recipients and taxpayers, but criminal convictions can deter fraud and abuse. Civil suits can also help recover money that can be returned to the Medicaid program to help patients.