|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.
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 on the detection, elimination, and prosecution of those who fraudulently obtain government benefits.
On 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.
|How do I report client fraud in Oregon? |
Please use only one method to report fraud. All complaints are given to the client fraud hotline coordinator.
- Report fraud online.
- Call the fraud hotline at 1-888-FRAUD01 (888-372-8301). You can talk to the hotline coordinator or leave a message during regular business hours (8:00 am to 5:00 pm Pacific Time).
- FAX your written complaint to: ATTN: HOTLINE at 503-373-1525.
- Mail your written complaint to: Investigations Unit PO BOX 14150 Salem, OR 97309
|How do I report other concerns or issues? |
|How do I report provider fraud? |
Please use only one method to report fraud.
All complaints are given to the fraud hotline coordinator.
- Report fraud online.
- 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.
- FAX your written complaint to: ATTN: HOTLINE at 503-378-2577.
- Mail your written complaint to: DHS Provider Audit Unit 3406 Cherry Ave NE, 2nd Floor, Salem, OR 97303.
|What happens after I file a client fraud complaint report?|
- Your complaint is taken or received by the fraud hotline coordinator.
NOTE: If you wish to remain anonymous, do not provide your name as it may be subject to public disclosure. If you choose not to remain anonymous, please provide your name and phone number so one of our investigators may contact you if any additional information is needed.
- The coordinator then sends a report of the allegations to the investigation unit for review.
- Allegations are referred to an investigator when appropriate.
- Substantiated criminal investigations results are thoroughly reviewed for prosecution referral.
- Information will be reported back to you. This is to preserve the confidentiality and privacy of client information.
|What happens after I report provider fraud? |
ODHS 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 ODHS for administrative action.
|What is client fraud in Oregon?|
Client fraud is fraud against the programs of the Oregon Department of Human Services (ODHS), 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 investigates 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 not reporting assets that exceed program resource limits. Examples of assets that may count towards resource limits in some programs include: 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.
|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 Oregon Department of Human Services (ODHS).
Investigations focus on client eligibility issues and benefit fraud. Investigators coordinate with staff from ODHS field offices, county prosecutors and with local, state, federal and international law enforcement agencies when necessary.
|What kind of provider fraud do you investigate? |
We investigate all fraud allegations made against ODHS providers and contractors. Some examples:
- Billing for services not rendered.
- Intentionally billing for services in duplicate.
- Billing for a higher level of service than what was delivered.
- Billing for services provided by unlicensed or otherwise ineligible practitioners.
- Kickback schemes.