Office of Inspector General: Report Fraud

If you suspect Medicaid or Welfare fraud (including Link Card, Illinois’ SNAP/Food Stamp program), please complete and submit the form below or call the Medicaid/Welfare Fraud Hotline at 1-844-453-7283/1-844-ILFRAUD.

First Name

Last Name

Sex

Male
Female

Street Address

City

State

Zip

Home Phone

Work Phone

Cell Phone

Preferred Method of Contact

Subject's First Name required

Subject's Last Name required

Subject's Age required

Subject's Date of Birth

Subject's Sex required

Male
Female

Subject's SSN (Last 4)

Subject's DHS Case Number

Subject's Street Address

Subject's City

Subject's State

Subject's Zip

Employer Name

Employer Address

Employer City

Employer State

Employer Phone

Other Income Type

Other Income Amount

How Often

Household Member Name

Age of Household Member

Relationship(i.e. mom, dad, husband)

Date of Death

County of Death

City of Death

State of Death

Complaint Detail required

Notified OthersHave you notified any other Federal, State, or Local agency of your complaint or filed a lawsuit or grievance related to these matters?

Agency NotifiedIf yes, with which agency did you file a complaint?

Complaint ResolvedHas your complaint been resolved?

Resolution SummaryIf yes, briefly summarize the results

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