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Fraud Reporting and Investigations Fraud Hotline: 1-888-FRAUD01(1-888-372-8301)
This page contains frequently asked questions on reporting fraud in Department of Human Services programs. DHS investigates Client and Provider Fraud in the state of Oregon. The word Client is used to include: Medicaid/Oregon Health Plan programs and benefits; food stamps; Temporary Assistance for Needy Families (TANF); Oregon Trail card, which is used for Electronic Benefits Transfer (EBT); and Childcare benefits. The word Provider is used to include: Medicaid/ Oregon Health Plan providers and other DHS Contractors.
Frequently Asked Questions
What is the Fraud Investigations Unit?
In the state of Oregon, the Fraud Investigations Unit has delegated authority to conduct investigations related to allegations of fraud within programs administered by the Department of Human Services. Investigations focus on Client eligibility issues and benefit Fraud. Investigators coordinate with staff at the DHS Field Offices, County prosecutors and with local, state, federal, and international law enforcement agencies when necessary.
What is Client Fraud in Oregon?
Client Fraud is fraud against the programs of the Oregon Department of Human Services (DHS), including unlawful practices in obtaining cash assistance, medical assistance, and/or food assistance. It is the intentional misstatement or failure to reveal information affecting eligibility resulting in an overpayment. The Fraud Investigations Unit investigate allegations such as the following:
Unreported Employment: The client is suspected of not reporting employment.
Unearned Income:The client is suspected of not reporting the receipt of recurring income not derived from employment.
Unreported Assets:The client is suspected of having one or more of the following assets: Real estate, vehicles, boats, motor homes, non-recurring monetary holdings, etc.
Unreported Child Support:The client is suspected of receiving unreported child support payments.
Unreported Marriage: The client is suspected of not reporting a marriage that may affect the grant amount.
Absent Parent in Home: The client is suspected of not reporting the presence of an absent parent in the home. This includes stepparents.
Child Out of Home: The client is suspected of applying for or receiving benefits for a child not present in the home.
Household Composition:The client is suspected of receiving assistance for an ineligible dependent or has not accurately reported the correct number of persons living in the household.
Address Verification:The client is suspected of not reporting their address information correctly.
Duplicate Grants: The client is suspected of applying for or receiving grants under multiple names.
False Identity: The client is suspected of submitting false identification to apply for or obtain a grant; or may be working under a false identity.
Felony Drug Conviction/Warrant: The client is wanted on an outstanding felony warrant, which may make the client ineligible for benefits.
Child Care Fraud: The client is suspected of improperly receiving child care payments or reporting a false provider.
EBT Fraud: The client is suspected of fraudulently using their Oregon Trail card or allowing their Oregon Trail card to be used by an unauthorized person.
Other: The client is suspected of any other improper procedure not covered by the other categories.
How do I report Client Fraud in Oregon?
Call the Fraud Hotline at 1-888-FRAUD01 (888-372-8301). You may talk to the Hotline Coordinator or leave a message during regular business hours (8:00 am to 5:00 pm Pacific Time).
What happens after I file a Client Fraud complaint report?
Can I report people committing Client Fraud in other states?
No. Client Fraud needs to be reported in the state where it was committed. The Fraud Investigations Unit only investigates Client Fraud in Oregon. To report fraud occurring in another state, please call that state's Fraud Reporting Hotline. Or, visit the website of the United Council on Welfare Fraud (UCOWF). UCOWF is an international organization of approximately 2,000 individuals from the United States and Canada who have combined their efforts to fight fraud, waste, and abuse in social service programs. Their primary focus is toward the detection, elimination, and prosecution of those who fraudulently obtain government benefits. At the UCOWF website, you may find additional information on Client Fraud and links to report fraud to other states.
Does an Oregon client have to repay benefits?
If a client has received benefits and is then found to be ineligible, they may be required to pay back the overpayment in accordance with state and federal laws.
What kind of provider fraud do you investigate?
We investigate all fraud allegations made against DHS Providers and Contractors. Some examples follow:
How do I report Provider Fraud?
Call the Fraud Hotline at 1-888-FRAUD 01 (888-372-8301). You may talk to the Hotline Coordinator or leave a message during regular business hours.
What happens after I report Provider Fraud?
DHS conducts preliminary investigations on all provider fraud referrals. At this point, a decision is made to either close the investigation or conduct a more thorough investigation.
Substantiated fraud investigations are referred to the Department of Justice or local district attorneys for consideration of prosecution. When a decision is made not to prosecute, the case is referred back to DHS for administrative action.
How do I report other concerns or issues?
Information regarding fraud in other states: United Council on Welfare Fraud (UCOWF)
Child Abuse issues: To report child abuse or neglect contact your local DHS Child Welfare office or email dhs.info@state.or.us You can find additional information on child welfare in the Children and Teens section of the DHS Web site.
Aging and Adult abuse issues: call 1-800-282-8096 - for more information: DHS Area Agencies on Aging & Seniors and People with Disabilities.
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