Fraud prevention

Falsely reporting circumstances to obtain Washington Apple Health coverage is insurance fraud.

This can include, but is not limited to, under-reporting income, reporting you are a resident when you live out of state, not indicating all your household members, and more.

How to report Medicaid fraud

You can help prevent misuse by reporting suspected Medicaid fraud.

Reporting recipients (patients) of Apple Health (Medicaid) coverage

If you suspect someone is fraudulently reporting their circumstances to receive Washington Apple Health (Medicaid) coverage, please notify:

Washington Apple Health eligibility fraud

  • Phone: 1-360-725-0934
  • Fax: 360-725-1158
  • Mail: Health Care Authority
    Attention: OMEP
    P.O. Box 45534
    Olympia, WA 98504-5534
  • Email: WAHEligibilityFraud@hca.wa.gov

Reporting Medicaid providers

Suspected Medicaid provider fraud may be reported by:

Reporting behavioral health facilities

Fraud and abuse are specific complaints or incidents about such things as service billing irregularities, coding that misrepresents the services provided (or not provided), instances of theft or embezzlement, conflicts of interest, provider self-referrals or ‘kickbacks’, or any other conduct that may be a violation of law or billing instructions. Your call or email is confidential.

If you have questions or concerns about these issues, or want to report an instance of fraud or abuse, contact: hottips@hca.wa.gov.

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