Arkansas Attorney General Dustin McDaniel | Complaints | Medicaid Fraud

En español
Sex Offender Search
Protection From
Online Predators
Consumer Tips
Identity Theft
Vehicles
Contact Us

Consumer Complaints

Medicaid Fraud Complaint Form

Date:

List Name(s) of the Medicaid Provider(s) Against Whom the Complaint Is Being Filed:

List Address of Medicaid Provider, if Known:

State Nature of Fraud/Abuse/Neglect Which You Observed:

List Name(s) of the Medicaid Recipient(s)/Resident(s) Who was(were) the Victim(s) of these Fraudulent, Abusive or Negligent Actions by a Medicaid Provider(s):

List Your Name, Address and Telephone Number so That We May Contact You for Additional Information. Please Provide Both a Day and Evening Telephone Number, if Applicable: