To Report Fraud or Abuse of Programs

Overview

REPORTING FRAUD IS EASY, SAFE AND SECURE

Note: Because of confidentiality laws we are NOT able to inform or respond to you as to the outcome or specifics of a case.

The Department of Social Services is strongly committed to identifying and eliminating fraud, whether it be committed by a client, provider or vendor.

Client Fraud

 

Client fraud is an “intentional” action which results in a client or another person receiving public assistance benefits which they are not entitled to from programs including, but not limited to, Care4Kids Child Care, Supplemental Nutritional Assistance (SNAP-formerly known as the Food Stamp program), Connecticut Energy Assistance (CEAP) and Medicaid.  Conduct that constitutes potential client fraud allegations include, but is not limited to:

 

  • Client is suspected of not reporting employment wages or a recurring income not resulting from employment
  • Client is suspected of not reporting their address information correctly
  • Client is suspected of not reporting the presence of another parent in the home
  • Client is suspected of receiving benefits for a child that does not live with them
  • Client is suspected of SNAP trafficking (formerly known as the Food Stamp program)
  • Client is suspected of applying for and receiving public assistance in more than one (1) state at the same time

 

Use the Client Complaint Form Opens in a new window Opens in a new window to report client fraud.

 

Provider/Vendor Fraud

 

Provider or Vendor Fraud is an “intentional” deception or misrepresentation which results in an unearned benefit to a provider or vendor, usually in the form of an excess payment, through the Medical Assistance Programs.  This would include any provider or vendor operating as an individual or business entity including their employees, owners and/or officers.  Conduct that constitutes potential provider or vendor fraud allegations include, but is not limited to:

  • Provider billing for services that were not rendered
  • Providing services which are not medically necessary
  • Provider billing for a covered service when a noncovered service was provided
  • Billing for a more costly service than was performed
  • Ordering excessive or inappropriate tests
  • Altering and/or falsifying a claim or records
  • Accepting kickbacks for patient referrals for services
  • Billing for brand-name drugs when generic drugs are dispensed

 

 Use the Provider/Vendor Complaint Form Opens in a new window Opens in a new window to report provider or vendor fraud. 

 

Please follow this link view to the Administrative Actions List.