Help Fight Fraud, Waste and Abuse

Medicaid pays health care providers and organizations like Blue Cross Blue Shield of Michigan to take care of patients. Sometimes, providers and patients misuse or abuse Medicaid benefits, leaving less money to help people in Michigan who need care.

What is fraud?

Let us know if you think a health care provider like a doctor, dentist or pharmacist is doing something wrong, or if you think a Medicaid receipient is misusing or abusing their benefits. Doing something wrong could be fraud, which is against the law, or waste or abuse.

For example, tell us if you think someone is: 

  • Getting paid for services covered by Blue Cross under the Healthy Kids Dental program that weren't given or necessary
  • Not telling the truth about a medical condition to get medical or dental treatment
  • Letting someone else use a Blue Cross Healthy Kids Dental program ID card
  • Using someone else's Healthy Kids Dental ID card
  • Not telling the truth about the amount of money or resources he or she has to get benefits

Learn more about dental insurance plans for children at Healthy Kids Dental.

How to report fraud

You can anonymously report fraud, waste and abuse by calling the phone numbers below: 

Or by sending a letter in the mail to the following address:

Blue Cross Blue Shield of Michigan
P.O. Box 491
Milwaukee, WI 53201-0491

You can also report fraud, waste or abuse directly to the Michigan Department of Health and Human Services using the following methods:

Michigan Department of Health and Human Services
Office of Inspector General
P.O. Box 30062
Lansing, MI 48909

1-855-MIFRAUD (643-7283)

Please visit the MDHHS fraud information website to contact MDHHS or to get more information.

What you will need to file a report

To report fraud, waste or abuse, gather as much information as possible. 

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

  • Name, address and phone number of the 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 phone numbers 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