How to Report Medicaid Fraud

The Iowa Department of Health and Human Services (HHS) works to make sure taxpayer money is spent the way it’s supposed to be, including for services that help people in Iowa, like Medicaid. We look into possible fraud or abuse in programs we fund, and we accept tips from anyone.

Below, you will find definitions of fraud and abuse, how to report, and what information you need to make a report.

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How to Report Fraud

To report a Medicaid member, family member, or caregiver:

Call the Member Fraud Hotline: 1‑877‑347‑5678 (toll free) 

OR 

Call the Federal Hotline (HHS‑OIG): 1‑800‑HHS‑TIPS 

To report a Medicaid provider:

Call the Provider Fraud Hotline: 1‑877‑446‑3787 (toll free) 

OR

Call the Federal Hotline (HHS‑OIG): 1‑800‑HHS‑TIPS 

To report Managed Care Plan (MCP) staff:

Use your health or dental plan's internal reporting process or use any of the Member or Provider methods listed above. 

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Reporting Questions

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Sanction List

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Fraud Data

Iowa Medicaid Fraud-Related Case Activity (SFY 2024–2026)  

All reports are reviewed, and credible allegations are referred to the Medicaid Fraud Control Unit for investigation. Iowa uses provider screening, audits, data analytics, and managed care oversight to prevent improper payments and has recovered more than $109 million since FY21.

Year  

Decline  

Open  

Prosecuted  

Referred  

2024  

27  

15  

0  

42  

2025  

33  

7  

1  

40  

2026  

15  

6  

0  

21  

Total  

75  

28  

1  

103  

  • Iowa’s case outcomes have remained stable over the past three years, even as overall case volume shifted.  

  • Case volume in 2026 dropped significantly, but the ratio of declines, open cases, and referrals stayed consistent, indicating strong triage and review processes.  

  • Iowa is monitoring whether reduced volume reflects better early screening, reporting shifts, or changes in federal investigative thresholds.  

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