Fraud Reporting

You can report directly to Aetna Better Health of Texas any providers or members you suspect of waste, abuse or fraud.  You can do so via US Mail, online through the form found below or on the Texas Health and Human Services Commission website. Note: even if you provide your contact information, your identity will be kept confidential to the extent allowed.

To report waste, abuse or fraud, choose one of the following:

  • Call the OIG Hotline at 1-800-436-6184
  • Visit Office of Inspector General and pick “Click Here to Report Waste, Abuse, and Fraud” to complete the online form.
  • Report directly to your health plan:

Aetna Better Health of Texas
Attention: SIU Coordinator
PO Box 569150
Dallas, TX 75356-9150
1-866-519-0916 (toll-free)

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

  • Name, address and phone number of 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.)

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
  • The type of complaint

Please describe the activity that may be fraud or abuse. Some examples are: 

  • Billing for services you did not receive
  • Billing for services that were not provided
  • Someone using your identity to receive medical services

Please provide details that tell us:

  • Names and phone numbers of other witnesses who can help in the investigation
  • Dates of events
  • Summary of what happened
  • If law enforcement was notified

Your contact information
Optional information: We would like to be able to discuss your response with you. Please provide your name, phone number, address and/or e-mail address below. We will contact you for more information if needed. Thank you for helping our efforts to detect fraud and abuse. 

* Required Fields

Fraud and Abuse Reporting Form

Optional information: You don’t need to give us your name or contact information. But if you do, we’ll keep it confidential. You can also choose to give us just your contact information and not your name.

If you choose not to give your contact information, our review will be only about the information you’re reporting. It’s important that you give us as much information as you can. It will help us do a complete and correct investigation.