Medicaid Fraud Control Unit Complaint Form

If you feel you have been the victim of or have information of Medicaid (AHCCCS) fraud; fraud in the administration of the Medicaid program; and abuse, neglect or financial exploitation occurring in Medicaid facilities or committed by Medicaid providers or their employee, please fill out the complaint form below, or download a printable complaint form.

 


 

Contact Info

Please complete this section if you are reporting an
Abuse, Neglect, or Financial Exploitation case.


 

Facility Contact Info

Please complete this section if you are reporting
Medicaid Fraud.


 

Provider Contact Info