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NC Department of Health and Human Services

NC Division of
Medical Assistance

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Medicaid Fraud and Abuse Confidential Online Complaint Form

How to Report Fraud and Abuse Information for Consumers

Fraud and Abuse Information for Providers

Medicaid Integrity Program (MIP)

Quality Assurance Forms

Third Party Information for Providers

DHHS > DMA > Contact DMA > Section Contacts >Program Integrity

Program Integrity Letters and Forms

Sample Program Integrity Letters:

Vendor Introduction Letter

Provider Payment Suspension Notice

Tentative Notice of Overpayments:

Tentative Notice of Overpayment

Tentative Notice of Overpayment: Credible Allegation of Fraud

Tentative Notice of Overpayment: Substantial Failure to Comply

Tentative Notice of Overpayments - Pharmacy:

Tentative Notice of Overpayment Pharmacy

Tentative Notice of Overpayment Pharmacy: Credible Allegation of Fraud

Tentative Notice of Overpayment Pharmacy: Substantial Failure to Comply

Self Audit:

Self-Audit Overview for Providers

Voluntary Self-Audit Forms

Provider Attestation

(The following form is editable and can be filled in electronically)

Provider Attestation Form: Catastrophic Event

Contact Information:
919-647-8000

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Updated: September 12, 2012