Reporting Fraud, Waste and Abuse

Care1st Health Plan Arizona is serious about finding and reporting times that Arizona Medicaid funds are used in the wrong way. This is called waste, fraud or abuse.

Absolutely anyone can report fraud, waste, or abuse. There are no restrictions.

You can contact AHCCCS or your Health Plan to report Provider or Member Fraud as follows:

You may also report Fraud, Waste, and Abuse to AHCCCS via one of the following methods:

  • Online Website: Report Member, Provider, or Contractor Suspected Fraud or Abuse of the Program
  • Telephonically (Provider Fraud):
    • In Arizona: 602-417-4045;
    • or outside of Arizona: 888-ITS-NOT-OK or 888-487-6686.
  • Telephonically (Member Fraud):
    • In Arizona: 602-417-4193;
    • or outside of Arizona: 888-ITS-NOT-OK or 888-487-6686.

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

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.)
  • 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 waste, abuse, or fraud