How to Report Medicare Fraud: Online, Phone, or Mail

To report Medicare fraud, file a complaint online through the HHS Office of Inspector General at oig.hhs.gov, call the OIG Hotline at 1-800-HHS-TIPS (1-800-447-8477), or call 1-800-MEDICARE (1-800-633-4227). Reports are free, can be filed anonymously, and work best when you have your Medicare Summary Notice in front of you and can point to specific charges, dates, and providers.

Check Your Medicare Summary Notice First

Medicare mails a Medicare Summary Notice (MSN) every three months to anyone who had services during that period. The MSN lists every service billed to Medicare under your name, when it happened, who billed for it, and what Medicare paid. It is the single best document for catching fraud, and reviewing it before you call anyone will save you time.

Go line by line. Do the dates line up with appointments you actually had? Are the provider names ones you recognize? Does the described service match what happened in the room? Watch for equipment you never received, charges on days you saw no one, a routine visit billed as something more complex, or the same service billed twice.

If something looks off, call the provider’s billing office first. Coding mistakes are common and often resolved with one phone call. If the answer you get doesn’t fit the facts, that’s when a fraud report is the right step.

What to Have Ready

A specific report moves faster than a vague one. Pull the following from your MSN or bills before you file:

The provider’s name and address, and the National Provider Identifier (NPI) if your MSN shows one. The NPI is a unique 10-digit number that lets investigators identify exactly who billed Medicare.
The specific dates of the suspicious services.
The amounts billed and the amounts Medicare paid.
Your Medicare number, which links the billing to your account.
A clear description of what’s wrong. For example: “I was billed for a 45-minute office visit on June 12, but the appointment lasted 10 minutes,” or “I never received the knee brace on my statement.”

You don’t need every one of these to file, and you don’t need proof that fraud occurred. Proving it is the investigator’s job. But the more concrete detail you supply, the more the OIG can do with your complaint.¹

Ways to File a Report

Online

The fastest route is the OIG’s online complaint form at oig.hhs.gov/fraud/report-fraud/. The form prompts you through the provider information, a description of the suspected fraud, and any documents you want to attach. When you submit, a confirmation page appears. Save or print it.

By Phone

Two hotlines take Medicare fraud tips. The OIG Hotline at 1-800-HHS-TIPS (1-800-447-8477) covers fraud, waste, and abuse in any HHS program. 1-800-MEDICARE (1-800-633-4227) goes to Medicare directly. Either works. Have the same information ready that you’d type into the online form.

By Mail

If you want to send paper documents or prefer writing, mail your complaint to:

U.S. Department of Health and Human Services
Office of Inspector General
ATTN: OIG Hotline Operations
P.O. Box 23489
Washington, DC 20026

Send photocopies of your MSN and any supporting materials, never originals. Include the same identifiers you’d give online so staff can enter your complaint into the same system.²

Medicare Advantage and Part D

If your coverage runs through a Medicare Advantage plan (Part C) or a prescription drug plan (Part D), you have an extra option: the Investigations Medicare Drug Integrity Contractor (I-MEDIC) at 1-877-7SAFERX (1-877-772-3379). I-MEDIC handles fraud tied to the private insurers that administer those benefits. It doesn’t replace the OIG or 1-800-MEDICARE. You can use both.³

If you aren’t sure whether what you’re seeing is fraud or a billing mistake, the Senior Medicare Patrol (SMP) program has counselors in every state who will walk through an MSN with you and route the complaint to the right agency. Find your local office at smpresource.org. Don’t send your Medicare number or Social Security number through any online form; share those only by phone or in person.⁴

Anonymous, Confidential, or Identified

When you file with the OIG, you choose how much of your identity to attach to the complaint, and the choice shapes what investigators can do with it.

Identified with no restrictions: you give your name and contact information, and the OIG may share your identity outside HHS-OIG when they judge it necessary to move the case forward.
Confidential: the OIG knows who you are but keeps that inside the office at your request. This can narrow what investigators can pursue, and the OIG may still disclose your identity if the investigation requires it or the law compels it.
Anonymous: you give no identifying information at all. This protects your privacy but rules out treating your report as a whistleblower retaliation matter and can make follow-up questions impossible.

If you initially agree to be identified and change your mind later, you can withdraw consent when an agent contacts you. The OIG may close the investigation if the withdrawal makes it impossible to resolve the allegations. Even anonymous reporters can be traced when public safety, crime prevention, or other lawful purposes apply.⁵

What Happens After You File

An OIG analyst reviews your complaint for relevance and completeness. Not every complaint becomes an investigation. Some are billing errors on closer look, and some don’t have enough detail to work with. If you identified yourself, someone may reach out for more information. If no one does, that isn’t proof your complaint was ignored.¹

The OIG doesn’t publish investigation timelines, and law enforcement confidentiality means you generally won’t get status updates. Cases involving a single suspicious charge move differently than cases involving billing patterns across multiple providers.

When fraud is confirmed, providers convicted of program-related crimes, patient abuse, or healthcare fraud felonies face mandatory exclusion from Medicare, Medicaid, and every other federally funded health plan.⁶

Whistleblower Rewards If You Have Inside Knowledge

If you work at a hospital, clinic, billing company, or supplier and you have direct knowledge of Medicare fraud, the False Claims Act offers something beyond a tip line. Under the “qui tam” provision, you can file a civil lawsuit on behalf of the federal government against the entity committing fraud, and if the case succeeds, you receive a share of what the government recovers.

Your share depends on how the case unfolds:

If the Department of Justice intervenes and leads the prosecution, you get between 15% and 25% of the total recovery.
If the government declines and you pursue the case yourself, your share is 25% to 30%.
If the court finds your case relies primarily on information already public through news reports, audits, or prior investigations, the award is capped at 10%.

You’re also entitled to reasonable attorney fees and litigation costs, paid by the defendant.⁷ The False Claims Act imposes civil penalties of $14,308 to $28,618 per false claim, plus triple the government’s actual damages, so a provider who submitted hundreds of false claims can face a recovery in the tens of millions.⁸ Most qui tam attorneys work on contingency, so you pay nothing upfront.

The False Claims Act also protects you against employer retaliation. If you’re fired, demoted, suspended, threatened, or harassed for reporting fraud or participating in an investigation, you can sue in federal court and, if successful, recover reinstatement at your prior seniority, double back pay with interest, and compensation for special damages including litigation costs and attorney fees. You have three years from the date of retaliation to file. The protection covers employees, contractors, and agents.⁷

If Someone Is Using Your Medicare Number

Not every fraudulent charge on an MSN comes from a dishonest provider billing for real visits. Sometimes another person is using your Medicare number to bill for services entirely. This is medical identity theft, and it’s dangerous beyond the money because false entries in your medical record can influence future treatment.

If your MSN shows services from providers you’ve never seen or for conditions you don’t have:

Call 1-800-MEDICARE to report the unauthorized use and ask for a review of the suspicious claims.
File with the OIG through the same online form or hotline.
Report the identity theft at IdentityTheft.gov, the FTC’s central tool, which generates a recovery plan and pre-filled letters to credit bureaus and other agencies.
Contact your local State Health Insurance Assistance Program (SHIP) at shiphelp.org for free counseling on untangling the billing.

Keep your own log of every call and every document. These cases often involve several agencies at once, and a personal timeline keeps details from slipping.³

1
Department of Health and Human Services Office of Inspector General. Before You Submit a Complaint
2
Office of Inspector General. Contact Us
3
Medicare. Reporting Medicare Fraud and Abuse
4
Senior Medicare Patrol. Report Fraud
5
Office of Inspector General. Disclosing Your Identity
6
Office of the Law Revision Counsel. 42 USC 1320a-7 – Exclusion of Certain Individuals and Entities From Participation in Medicare and State Health Care Programs
7
Office of the Law Revision Counsel. 31 USC 3730 – Civil Actions for False Claims
8
Federal Register. Civil Monetary Penalty Inflation Adjustment