How do I report fraud/abuse? Options are:


  1. Complete the online form
  2. Call the Fraud Hotline number at 1-866-348-1129 or one of the numbers specified below depending on the type of fraud you are reporting.

All reports of fraud and abuse will be fully investigated. Please note that confidentiality laws do not allow us to share findings back to those who report potential fraud or abuse.

Provider Fraud and Abuse

Examples include: billing for services not delivered; overbilling for services.

Who do you call?

  • Program Integrity: 1-207-287-4660. Program Integrity will refer reports that require criminal investigation to the Attorney General’s Healthcare Crimes Unit at 1-207-626-8870 or email hcu.ag@maine.gov


Member or Client Fraud and Abuse:

Examples include: Inappropriately seeking drugs by going from doctor to doctor; obtaining prescribed medication and selling it to another party; buying medications from a MaineCare member.

Who do you call?

  • Program Integrity: 1-207-287-4660. Program Integrity will refer reports that require criminal investigation to the Attorney General's Healthcare Crimes Unit: 1-207-626-8870 or email hcu.ag@maine.gov

The Program Integrity phone line is staffed, however depending on the volume of calls you may receive voice mail. Staff will only return phone calls if additional information is required.


Eligibility fraud and abuse:

This covers MaineCare and other benefit programs like the Food Supplement Program and TANF:

Examples include: Receiving services or other benefits by falsifying information; not reporting income; not reporting changes in household size and income; not reporting assets (trusts).

Who do you call?

The Fraud Investigation and Recovery phone line is staffed, however depending on the volume of calls you may receive voice mail. Staff will only return phone calls if additional information is required.


What Constitutes Fraud in the MaineCare Program?

The MaineCare Benefits Manual, Chapter I, § 1.20-1 defines fraud as:

"Fraud includes intentional deception or misrepresentations, oral or written, which an individual knows to be false, or does not believe to be true, made with knowledge that deception or misrepresentation could result in some unauthorized benefits. The requisite intent is present if the misrepresentation was made knowingly or with reckless disregard for the truth"