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ALERT! We now encourage our patients to save their spot in line before coming into the clinic.

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Postpartum Medicaid and CHIP Coverage Extension | Learn more

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Fraud, Waste and Abuse Prevention

Texas Children’s Health Plan has a fraud, waste and abuse plan that complies with state and federal law. It is your responsibility as a participating provider to report any member or provider suspected of potential fraud, waste or abuse. All reports will remain confidential.

Let us know if you think a doctor, dentist, pharmacy, and/or a member is committing potential fraud, waste and/or abuse. Potential fraud, waste and abuse examples include but are not limited to:

  • Being paid for services that were not given or necessary.
  • Not telling the truth about a medical condition to receive medical treatment.
  • Letting someone else use a Medicaid (STAR) or CHIP ID.
  • Using someone else’s Medicaid (STAR) or CHIP ID.
  • Not telling the truth about the amount of money or resources he or she has to get benefits.
  • Intentional misrepresentation made to receive payments or benefits.
  • Overuse or misuse of services that are inconsistent with sound medical, business or fiscal practices.
  • Extravagant, careless or needless expenditure of government funds.

To report waste, abuse or fraud, choose one of the following:

  • Call the OIG Hotline at 1-800-436-6184 • Visit Click on the red box at the top right of the screen labeled “Report Fraud” to complete the online form
  • You can report directly to Texas Children’s Health Plan at:
    • Email:
    • Fax: 832-825-8722
    • Mail: Texas Children’s Health Plan, Controls and Compliance Department
    • P. O. Box 301011 Houston, TX 77230-1011
    • 1-832-828-1320