MedicaidAdministrativeMedium impact
Reporting Fraud and Abuse
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Mar 1, 2012
We identified it
Jun 20, 2026
Summary
Wisconsin DHS has established an Office of the Inspector General (OIG) to monitor fraud and abuse in state healthcare programs. Healthcare providers are now required to report suspected fraud, waste, or abuse through the OIG fraud reporting website or hotline when they have reason to believe misuse is occurring.
Action Required
Immediately: All staff must be trained on recognizing fraud and abuse indicators. Establish protocol to report suspected fraud via www.reportfraud.wisconsin.gov or (877) 865-3432. Document detailed descriptions including nature, scope, timeframe, names, dates of birth, and occurrence frequency when reporting. Front desk and billing staff should monitor for ForwardHealth card misuse but may not confiscate cards.