Skip to Content
Colorado Attorney General

Phil Weiser

Colorado Attorney General

File A Complaint
  • About Us
    • Attorney General Bio & Photos
    • Vision & Values
    • Senior Staff & Organization
    • Colorado Attorney General Annual Report
    • Attorney General Opinions
    • Contact Our Office
  • Sections
    • Administration
    • Business & Licensing
    • Civil Litigation & Employment Law
    • Consumer Protection
    • Criminal Appeals
    • Criminal Justice
    • Natural Resources & Environment
    • Division of Community Engagement
    • Revenue & Utilities
    • State Services
  • Careers
    • Attorney & Other Non-Classified Positions
    • Fellowships
    • Internships
    • Classified Staff Positions
    • Other Opportunities to Join our Team
  • Media Center
    • Press Room
    • Colorado Open Records Act – CORA
  • Resources
    • Survivors of Childhood Sexual Abuse
    • Victim Assistance
    • Budget & Accounting
    • Colorado Privacy Act
    • Code of Colorado Regulations
    • Colorado Revised Statutes
    • Coronavirus Information
    • Data Protection Laws
    • Funding Opportunities
    • Office of Financial Empowerment
    • Student Loans
    • Transparency Online Project (TOPS)
  • Licensing
    • Business Resources
    • Collection Agencies & Debt Collectors
    • UCCC Licensing & Notification
    • Debt Management Services Providers
    • Health Club Bonds
    • Repossessors
    • Student Loan Servicers: Licensing
    • Telemarketing
  • Recursos en español

Medicaid Fraud, Patient Abuse and Neglect

What is the Colorado Medicaid Fraud Control Unit (COMFCU)?

The Colorado Medicaid Fraud Control Unit (COMFCU) is tasked with protecting the system that provides health care to those most in need in Colorado.  Dedicated to the investigation and prosecution of Medicaid provider fraud and the investigation and prosecution of the abuse and neglect of the most vulnerable Coloradans.  The COMFCU maintains a strong commitment to ensuring that Coloradans have access to the highest quality care from dedicated providers while continuing to take an aggressive approach to reducing Medicaid fraud and patient abuse across the state.

What categories of cases does the COMFCU pursue?

  • Fraudulent conduct by Medicaid providers and individuals involved with providing Medicaid services.
  • The abuse, neglect, and exploitation of individuals in health care facilities that receive Medicaid funds or in board and care facilities.
  • The recovery of Medicaid overpayments identified in the investigation of fraud, patient abuse and neglect, and financial exploitation of clients.
Examples of Medicaid cases
  • Billing for goods or services not provided
  • Inflating the bills for goods and services that are provided
  • Billing for phantom patient visits
  • Billing for medically unnecessary medical testing and procedures
  • Falsification of credentials by Medicaid providers
  • Billing for Items not needed, ordered or delivered
  • Billing for old items as new
Examples of patient abuse, neglect and exploitation cases
  • Physical or sexual assaults
  • Unlawful use of restraints or confinement
  • Failure to provide medical care
  • Failure to ensure that a patient’s basic needs are met
  • Failure to monitor patient status
  • Misuse of patient funds

Tips on submitting a complaint

The more information you can provide about the situation, the more useful your complaint will be.  If possible, be prepared to provide the following information:

What is your issue about?

Be clear and concise. Briefly describe your issue and what steps you have taken to resolve it. Be sure to include all relevant dates and other details about your experience, including the amount of money lost (if any) and communications you have had with the alleged suspect, witnesses, and involved insurance company or companies.

Information about the situation/suspect(s)

If available, please be prepared to provide information on the situation you are reporting about, such as suspect name, address, phone number, website, email address, and any other identifying information.

Your contact information

Please be prepared to provide your contact information, such as your name, address, phone number, and your email address.

File a Complaint

Important Notice
The Attorney General’s Office does not have authority to provide legal advice or legal representation to individuals and does not have the authority to investigate or prosecute your individual case.

Click here to locate your district attorney’s office.

Criminal Justice

The Criminal Justice Section investigates and prosecutes on a statewide basis a broad array of matters including but not limited to: securities fraud, insurance fraud, Medicaid fraud, environmental violations, human trafficking, drug trafficking homicides, and multi-jurisdictional organized crime.

This work is accomplished either under the original jurisdiction of the Attorney General’s Office, or in partnership with and at the request of state and federal prosecutors and law enforcement.  Click here to learn more.

Additional Resources

StopFraudColoradoNeed more information?  Please visit our Medicaid Fraud Center where we have compiled information about various topics. Please note you will be routed to the Colorado Attorney General’s Consumer Fraud initiative, StopFraudColorado.gov

  • Medicaid Fraud Center
  • Report Medicare Fraud

 

Consulte esta página en español

Haga clic o pulse aquí para ver esta página en español.

Office of the Attorney General
Colorado Department of Law
Ralph L. Carr Judicial Building
1300 Broadway, 10th Floor
Denver, CO 80203

(720) 508-6000

Contact the Office of the Attorney General

Contact

Facebook
Twitter
i5gKjCdo97Hi0J5uNM12g_CJWFchg-pkj9Ah0VPNrJA=.html