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Who do I send my report to?
If you suspect fraud, waste or abuse related to your Aetna Better Health® of Texas coverage, you can:
Call us
Report suspected cases to the Aetna Better Health of Texas Fraud and Abuse Hotline:
1-866-519-0916 (TTY: 711)
Call the state
Report suspected cases to the Office of Inspector General Hotline (Texas Health and Human Services):
Mail a report
You can mail your report to:
Aetna Better Health of Texas
Attention: SIU Coordinator
PO Box 818042
Cleveland, OH 44181-8042
Provider fraud, waste and abuse
Provider fraud, waste and abuse
Provider fraud, waste and abuse includes:
- Using false info on medical records
- Prescribing more medication than a person needs
- Giving more health care services than a person needs
- Billing for items or services without providing them
- Billing for professional services when a medical professional didn’t perform the service
When reporting about a provider, you should include:
- Provider name, address and phone number
- Name and address of hospital, nursing home, home health agency, etc.
- Provider or office Medicaid number, if you have it
- Type of provider (doctor, dentist, therapist, pharmacist or other)
Member fraud, waste and abuse
Member fraud, waste and abuse includes:
- Lending, selling or giving a health plan ID card or Texas benefits Medicaid card to someone else
- Getting the same treatments or medications from more than one provider
- Using someone else’s Social Security number or health plan ID number
- Receiving money or gifts in return for using medical services
When reporting about members, you should include the:
- Person’s name
- Person’s date of birth, Social Security number or case number, if you have it
- Person’s phone number and address
- City where the person lives
- Type of complaint
Tips on reporting
Tips on reporting
Describe the action that may be fraud or abuse. Some examples are when:
- A provider bills you for services that you didn’t receive or that weren’t provided
- Someone else uses your identity to get medical services
You’ll want to know the answers to these questions:
- What are the names and phone numbers of people who can help with the investigation?
- When did the event happen (dates)?
- What happened (a summary)?
- Did someone call the police?
Your info stays private
Your identity and contact info will be kept private to the extent the law allows.
