Report Fraud

Person or Business Suspected of Misuse or Fraud

What type of problem are you reporting? (Please check one box.)

  • Provider
    Recipient
    Cash Assistance
    Medicaid/RIte Care/RIte Share
    Child Care
    Food Stamps
    Child Support
    Other
  • Name of person(s) or business(es) you are reporting

    (Please include title, e.g., Dr., Mr., Mrs., Ms. if known.)

  • Other names or aliases (if known)

  • Social Security Number (If known, please enter as 999-99-9999.)

  • Address

  • Phone Number (Please include area code and enter as (999) 999-9999.)

  • Employer's Name

  • Employer's Address

  • Employer's Phone (Please include area code and enter as (999) 999-9999.)

  • Complaint

  • Yes
    No
  • Optional Contact Information

  • You may remain anonymous if you desire. Providing contact information will allow the DHS Rhode Island Fraud office to contact you to gather any additional information needed to help in the investigation.

  • By providing my name on this form, I realize that I may be contacted by DHS and/or other law enforcement agencies in order to verify this information. However, DHS will not provide the results or status of the investigation to me or anyone else. Should I not provide my name, this referral remains fully confidential.