Office of Medicaid Program Integrity

Medicaid Fraud and Abuse Complaint Form

The below Medicaid fraud and abuse complaint form should be used to report MEDICAID PROVIDER FRAUD, which includes suspected fraud or abuse committed by Medicaid Health Plans, Medicaid providers, and other individuals or entities who bill the Medicaid program or engage in activities that cause Medicaid to reimburse claims should be submitted through this form.

Complaints about Recipients, non-Fraud issues, and licensure issues should be reported as follows:

• To REPORT MEDICAID RECIPIENT FRAUD, including eligibility issues, please use this link to report Public Assistance Recipient Fraud to the Florida Department of Children and Families.
• To FILE A MEDICAID-RELATED COMPLAINT that is not alleging Recipient or Provider fraud, please see the Florida Medicaid Complaints page.
• To FILE A COMPLAINT AGAINST A LICENSED HEALTH CARE FACILITY (or an unlicensed facility) regulated by AHCA use the Health Care Facility Complaint Form.
• To FILE A COMPLAINT RELATED TO A HEALTH CARE PROVIDER’S QUALITY OF CARE use this Florida Department of Health link to access the Florida Health Care Complaint Portal.
• To REQUEST WHISTLE-BLOWER PROTECTION, you must file your complaint with the Chief Inspector General or the applicable Agency Inspector General. You can file a complaint with the AHCA Inspector General through their complaint form.

MPI receives complaints alleging Medicaid PROVIDER fraud or abuse using the below form. You can report suspected fraud without giving your name and contact information. However, providing your contact information will help our investigation.