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​Fraud and Abuse

Suspect child abuse? Report it! 

Call ChildLine at 1-800-932-0313. 

Mandated reporters: Report electronically  

Issues with reporting electronically? Call ChildLine at 1-800-932-0313.


Abuse of an Adult with a Disability

Suspect abuse of an older adult living with a disability? Report it!

Statewide Abuse Hotline: 1-800-490-8505.

  • A Guide to Victim's Assistance — Learn about the resources available to victims after abuse, neglect, financial exploitation, or other crimes such as domestic violence, sexual assault, simple and aggravated assault, harassment, theft, and homicide


Medicaid Fraud

Unfortunately, a small number of Medicaid recipients and providers engage in practices that are fraudulent or abuse of the Medicaid program. The Department of Human Services (DHS) is committed to eliminating all forms of fraud and abuse within the Medicaid program. Your help will enable us to accomplish this goal. 

Report Suspected Fraud or Abuse with the MA Provider Compliance Response FormOpens In A New Window


Welfare Fraud 

Call the Fraud Tipline at 1-844-DHS-TIPS or report provider and/or recipient fraud with the online form.

Privacy Policy

The Office of Administration's Bureau of Program Integrity (BPI) requires that all employees maintain strict confidentiality concerning the facts of the cases to which they are assigned. No information obtained in the course of conducting reviews may be used for purposes other than the official administration of the Medical Assistance (MA) Program. The overall guiding principle is to provide for the minimum necessary use and disclosure of protected health information required to accomplish the objectives of BPI.

Medical records and claims information are used to determine the necessity, quality and appropriateness of services billed, the accuracy of the coding/billing, resolution of patient complaints, recipient restriction, and for evaluation of the MA Program.

Information may be provided for purposes of treatment, payment, and health care operations. Assisting in investigations, prosecutions, and civil or criminal proceedings related to the administration of the MA Program are all considered health care operations for which necessary disclosure is appropriate. The medical assistance application signed by recipients includes an authorization for release of personal, financial, and medical information for the purpose of determining eligibility and for review of the MA Program.

BPI closely monitors the disclosures of personal health information. Any information shared by BPI with other government agencies/medical professionals/contracted associates must be subject to the same applicable rules and regulations regarding protected health information.



 

 Content Editor ‭[2]‬

The Pennsylvania Department of Human Services (DHS), which is in part comprised of the Office of Children, Youth, and Families (OCYF) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.