Medicaid Fraud & Patient Abuse Unit Complaint Form

Please read the following information first

Completing the form below will allow you to contact the Office of the Attorney General. Certain information is required to process your message. Because of the large volume of e-mails received daily, there may be a delay in responding to your message.

Note on Anonymous Complaints:

Please be aware that while anonymous complaints will be thoroughly investigated to the best of our abilities, in most instances, investigators have follow-up questions which can assist in the investigation and can only be answered by the complainants. If you desire, during the process of speaking with investigators, you will be able to remain anonymous. Rhode Island General Laws are in place to protect “Whistleblowers”. Employers may not take retaliatory actions or discriminate against employees who file complaints against them.

If you would like to remain anonymous and speak with an investigator over the phone, please call: 401-274-4400- ext. 2446

Requirements of employees to report crimes in facilities:

Please note that there are state and federal laws which require the reporting of crimes by those individuals employed at facilities who have a reasonable belief that a crime has been committed at said facility.

Fields marked with * are required

This web form utilizes a CAPTCHA function to prevent spam submissions. If you are experiencing difficulty using this form, please call 401-274-4400 to submit a Medicaid fraud and patient abuse complaint.

Reporting Party Contact Information

First

Last

Street Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Best phone number

When is the best time for an investigator to contact you?

Victim/Patient information

First

Last

Street Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Best phone number

Facility/Medicaid Provider information

Name/Organization

Street Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Phone

Alleged perpetrator information

First

Last

Street Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Date of birth (if known)

Physical description (approximate age, height, weight, demographic, etc.)

Date of incident(s)

Alleged act or concern

Date of incident(s)

Alleged act or concern

Your relationship with the victim/patient?

Have you contacted another organization (law enforcement or state agency) regarding this matter? Please list, if so.

I certify that the information contained in this submission does not contain protected health information.

State law does not authorize the Attorney General to give individual citizens legal advice or opinions on statutory interpretation, or to act as their private attorney. The Attorney General serves as the state's chief legal officer responsible for providing legal representation to the State of Rhode Island and protecting the public interest.

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