How We Handle Complaints
The Staff at DHCS Stop Medi-Cal Fraud Intake Unit handle all inquiries regarding Medi-Cal Fraud. We receive hundreds of fraud complaints daily by e-mail, the Stop Medi-Cal Fraud and IHSS Fraud Hotlines, hard mail and directly from various other agencies.
- The Intake Unit responds to all inquiries, calls and e-mails
- Staff processes the information and inputs it into a tracking data base
- As needed, staff will contact the reporting party to verify, seek or clarify information
- Staff analyzes the complaint and determines if it should be referred to one of the regional Audits and Investigations offices for investigation and resolution.
- Investigators interview witnesses, evaluate claims data, conduct data searches and perform other investigation activities.
- If sufficient evidence exists, A&I will refer the case to the Department of Justice or to a local District Attorney's Office
NOTE: Due to HIPAA and Law Enforcement guidelines, Intake Unit Staff are unable to provide the status or resolution of a complaint.
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