AmeriHealth Caritas

How to Report FWA Related to NEMT in Louisiana

1. Louisiana Department of Health (LDH) – Medicaid Provider Fraud Complaints

You can submit a report online, by phone, fax, or mail:

• Phone (toll-free):
• Provider fraud: 1-800-488-2917
• Beneficiary fraud: 1-888-342-6207 Louisiana Department of Health
• Online Digital Forms: Submit electronically via:
• Provider Fraud Form
• Beneficiary Fraud Form Louisiana Department of Health
• Fax:
• Provider fraud: 225-216-6129
• Beneficiary fraud: 225-389-2610 Louisiana Department of Health
• Mail:
• LDH Program Integrity Unit – Provider Complaints
  P.O. Box 91030, Baton Rouge, LA 70821
• For beneficiary complaints, the same P.O. Box applies Louisiana Department of Health

2. AmeriHealth Caritas Louisiana – FWA Reporting (if applicable to your health plan)

If your complaint relates to AmeriHealth Caritas Louisiana:

• Fraud Tip Hotline: 1-866-833-9718 (Mon–Fri, 7 a.m.–6 p.m. CST)
• Online Reporting: Via the U.S. Department of Health and Human Services’ Office of Inspector General secure form AmeriHealth

3. Managed Care Organizations (other MCOs like Louisiana Healthcare Connections)

• For Louisiana Healthcare Connections (Centene), there is a confidential anonymous WAF hotline: 1-866-685-8664 Louisiana Healthcare Connections
• Or email their Special Investigations Unit at: Special_Investigations_unit@centene.com Louisiana Healthcare Connections

Template: FWA Tip Report – NEMT (Louisiana)

Below is a structured form/template you can adapt based on how you plan to submit (online, email, mail):

FWA Tip Report – Non-Emergency Medical Transportation (NEMT)

1. Your Contact Information (optional)

• Name: [Leave blank if anonymous]
• Phone:
• Email:
• Address:

1. Subject of Report

• Entity or Individual Involved:
  (e.g., MediTrans driver, NEMT broker, beneficiary, etc.)
• Role in NEMT System:
  (e.g., provider, broker, beneficiary, MCO plan member)

1. Details of Suspected FWA

• Dates and Times:
  (When did the incident(s) occur?)
• Location(s):
  (Pick-up/drop-off addresses or service areas)
• Description of the Alleged Fraud, Waste, or Abuse:

Examples:

• Billing for services not rendered (e.g., “I scheduled rides on January 10, but no ride occurred; yet a trip was claimed.”)
• Up-coding (e.g., billing wheelchair transport when ambulatory ride provided)
• Charging for multiple rides in one trip
• Suspicious denial patterns or inflated claims
• Supportive Evidence (if available):
  (Trip confirmations, timestamps, receipts, emails, witness names, etc.)

1. Impact

• Who was affected:
  (Name of beneficiary, impact on care, financial harm, missed appointments)

1. Desired Outcome / Request

• Initiate investigation
• Prevent future occurrences
• Request action or remediation

Complaint / Grievance Form