Reporting Fraud, Waste and Abuse

Do you want to report fraud, waste or abuse?
Let us know if you think a doctor, dentist, pharmacist at a drug store, other health-care providers, or a person getting benefits is doing something wrong. Doing something wrong could be fraud, waste or abuse, which is against the law.

For example, tell us if you think someone is:

  • Getting paid for services that weren’t given or necessary.
  • Not telling the truth about a medical condition to get medical treatment.
  • Letting someone else use their Medicaid ID.
  • Using someone else’s Medicaid ID.
  • Not telling the truth about the amount of money or resources he or she has to get benefits.

To report fraud, waste or abuse, choose one of the following:
Call the Office of Inspector General (OIG) Hotline at 1-800-436-6184 or fill out the OIG form online. Report directly to Superior at:

Superior HealthPlan
Attn: Compliance Department
5900 E. Ben White Blvd.
Austin, TX 78741
1-866-685-8664
To report fraud, waste or abuse, gather as much information as possible.

When reporting about a provider (a doctor, dentist, counselor, etc.) include:

  • 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 if you have it.
  • Type of provider (doctor, dentist, therapist, pharmacist, etc.).
  • Names and the number of other witnesses who can help in the investigation.
  • Dates of events.
  • Summary of what happened.

When reporting about someone who gets benefits, include:

  • The person’s name.
  • The person’s date of birth, social security number or case number if you have it.
  • The city where the person lives.
  • Specific details about the fraud, waste or abuse.

Texas Health and Human Services Notice about Reporting Medicaid Fraud