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.
- 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
- 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:
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.
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.
Please be prepared to provide your contact information, such as your name, address, phone number, and your email address.
File a Complaint
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.