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Report Fraud, Waste and Abuse

Understanding the terms:

  • Fraud: Intentional deception or misrepresentation to obtain the money or property of a health care benefit program (by means of false or fraudulent pretenses, representations, or promises).
  • Waste: The over-utilization of services or other practices that result in unnecessary costs.
  • Abuse: Obtaining payment for items or services when there is no legal entitlement to that payment, but without knowing and/or intentional misrepresentation of facts to obtain payments.

What can you do to help prevent, report, and stop Fraud, Waste, and Abuse?

Report potential fraud:

Contact Arizona Complete Health

  • Fraud and Abuse Hotline: 1-866-685-8664
  • Arizona Complete Health Attn: Compliance Officer
    1870 W. Rio Salado Parkway
    Tempe, AZ 85281
  • Email: AZFWA@Centene.com  

Medicare Fraud Hotline of the HHS office Inspector General

HHSC/OIG Inspector General

Contact Arizona Medicaid (AHCCCS)

  • Mail: Office of Inspector General (OIG)
    801 E. Jefferson St.,
    Mail Drop 4500
    Phoenix, AZ, 85034
  • To Report Provider Fraud:
    • In Maricopa County: 1-602-417-4045
    • Outside of Maricopa County: 888-ITS-NOT-OK or 1-888-487-6686
  • To Report Member Fraud:

In addition to notifying the regulators above, providers must immediately notify Arizona Complete Health of all suspected fraud, waste, and/or program abuse. Arizona Complete Health providers must report suspected fraud, waste, and program abuse directly to the health plan immediately upon identification and notification to their regulator(s).