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Fraud Complaint Forms


These forms require Adobe Reader®.   Adobe Reader® 9 or later, is recommended to support the additional functionality of the forms. The latest version of Adobe Reader® Link to External Website is available as a free download from Adobe's web site.

PLEASE READ if you are using a Mac™ or Google Chrome™ or Firefox 19.0™

Select the type of fraud you would like to report.

Claimant Fraud adobe pdf

Employer Fraud adobe pdf

Health Provider Fraud adobe pdf