Skip to Main Content

Report Fraud, Waste and Abuse

REPORTING FRAUD, WASTE AND ABUSE:

All employees and subcontractors of the Health Plan are responsible for reporting suspected Fraud, Waste and Abuse. The Oregon Market is required to report, regardless of its own suspicions or lack thereof, within seven days all suspected cases of Fraud, Waste and Abuse. The Director of Compliance or a designee will report all suspected cases by any employee or subcontractor while the SIU department will report cases by providers.

Individual whistleblowers or any other person(s) who make a report of suspected Fraud, Waste, Abuse, or non-compliance to Contractor, or its Subcontractors, shall not be required to use the FWA Referral Form or be required to include identifying information in their anonymous reports. All anonymous FWA reporting shall be accepted by Contractor, Subcontractors, and Participating Providers.

The reports are sent, at no cost, to:

Medicaid Fraud Control Unit (MFCU)

Oregon Department of Justice
100 SW Market Street
Portland, OR 97201
Phone: 971-673-1880ma
Fax: 971-673-1890
Email: Medicaid.Fraud.Referral@doj.state.or.us

OHA Office of Program Integrity (OPI)

500 Summer St. NE E-36
Salem, OR 97301
Secure email: OPI.Referrals@oha.oregon.gov
Hotline: 1-888-FRAUD01 (888-372-8301)
Report Fraud to OHA

The Oregon Market, if made aware of suspected Fraud or Abuse by a Member (e.g. a Provider reporting Member FWA) must promptly report the incident to the DHS/OHA Fraud Investigation Unit. Such reporting may be made by mail, phone, or facsimile transmission using the following contact information:

ODHS Fraud Investigation Unit

PO Box 14150
Salem, OR 97309
Hotline: 1-888-FRAUD01 (888-372-8301)
Fax: 503-373-1525 Attn: Hotline
Report Fraud to OHA

Excluded providers or subcontractors who are identified during the credentialing process are immediately reported to