Civil Medicaid Fraud

The Civil Medicaid Fraud Section (CMF) is nationally recognized as a leader in the recovery of funds wrongfully taken from the Medicaid program.

The group protects taxpayers by enforcing the Texas Medicaid Fraud Prevention Act (TMFPA), chapter 36 of the Texas Human Resources Code. The TMFPA permits private citizens to file lawsuits on behalf of the state against those who violate the TMFPA. These private citizens are referred to as "relators" and they assist the state in identifying and pursuing fraudulent activity committed against the Medicaid program. Relators in successful matters receive a portion of the recovery. The OAG may also pursue cases on its own on behalf of the Medicaid program.

In addition to actively litigating in state and federal courts, CMF works with relators, the criminal Medicaid Fraud Control Unit, the federal government, other state governments, and law enforcement to effectively conduct nationwide fraud recovery efforts. Through these efforts, the OAG has recovered over a quarter of a Billion dollars on behalf of the Texas Medicaid system.

Report Medicaid Fraud Violations

If you believe an individual is fraudulently receiving Medicaid benefits, contact the Texas Health and Human Services Commission's Office of Inspector General at:

Texas Health and Human Services Commission
Office of Inspector General
PO Box 85200
Austin, Texas 78708-5200
(800) 436-6184

To report a medicaid provider for fraud or abuse, contact our Medicaid Fraud Control Unit at:

Office of the Attorney General
Medicaid Fraud Control Unit
PO Box 12307
Austin, Texas 78711-2307
(512) 463-2011
(800) 252-8011 (Main agency switchboard)
mfcu@oag.state.tx.us
Medicaid Fraud Control Unit Regional Offices