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Fraud, waste and abuse

You have the right to report anyone that you believe is committing fraud, waste or abuse against the Medi-Cal system.

Who do I send my report to?

If you suspect fraud, waste or abuse related to your Aetna Better Health® of California coverage, you can:

File online

Fill out our online fraud, waste and abuse form.

Call us

Report suspected cases to Aetna Better Health of California's Fraud and Abuse hotline: 

1-855-321-3727 (TTY: 711)

Call the state

Report suspected cases to the state of California's Medicaid Fraud and Abuse hotline:

1-800-822-6222

Mail a report

You can mail your report to:

Aetna Better Health of California
Attn: Special Investigations Unit
10260 Meanley Drive
San Diego, CA 92131

Provider fraud

Provider fraud

Provider fraud, waste and abuse includes:
 

  • Falsifying medical records
  • Prescribing more medication than is medically necessary
  • Giving more health care services than medically necessary
  • Billing for services that were not rendered
  • Billing for items not provided
  • Billing for professional services when a medical professional did not perform the service

Member fraud

Member fraud

Member fraud, waste and abuse includes:
 

  • Lending, selling or giving a health plan ID card or Medi-Cal Benefits Identification Card (BIC) to someone else
  • Getting similar or the same treatments or medicines from more than one provider
  • Going to an emergency room when it is not an emergency
  • Using someone else’s Social Security number or health plan ID number
  • Receiving money or gifts in exchange for having medical services