Washington State

Office of the Attorney General

Attorney General

Bob Ferguson

How do I know if I qualify for Medicaid?

The Health Care Authority has information on its website, and Washington Health Plan Finder has this calculator available to help review what plans and assistance you might be eligible for. 

Where can I find Medicaid providers?

The Health Care Authority has a hotline that you can use to locate a provider, Medical Assistance Customer Service Center (1-800-562-3022) or you can visit their website to review a list.

I received a bill for a service I thought was covered by Medicaid, what should I do?

Medicaid usually covers the full cost of treatment for its clients, with rare exceptions, so providers normally would not bill you. First, call whoever is billing you to find out why they are billing you. If you still feel you should not have to pay it, call the Customer Service Center as quickly as possible at 1-800-562-3022. The operators will take your complaint and someone will look into your case quickly.

Who is considered a vulnerable adult?

A vulnerable adult is defined by law as:

  • a person 60 years of age or older who lacks the functional, physical or mental ability to care for him or herself;
  • an adult with a developmental disability per 71A.10.020;
  • an adult with a legal guardian per 11.88 RCW;
  • an adult living in a long-term care facility (an adult family home, boarding home or nursing home);
  • an adult living in their own or family’s home receiving services from an agency or contracted individual provider; or an adult self-directing their care per law (74.39.050 RCW).

Additional information regarding reporting fraud and/or abuseprotecting seniors and Medicaid Fraud is also available.   

What should I do if I suspect welfare or recipient Fraud?

The following site is for reporting suspected welfare or recipient fraud. If you have information regarding someone who is receiving benefits from the State of Washington but may not be reporting accurately please report that here or by calling 1-800-562-6906. You may choose to remain anonymous.
 
https://wadshs.libera.com/Sys7CMSPortal-FCMS-WA/fraud/report.aspx  

 

Qui Tam Whistleblower / Medicaid Fraud

Whistleblowers who bring qui tam actions must serve a copy of their complaint and written disclosure of substantially all material evidence and information the person possesses on the Attorney General in electronic form.  The Attorney General’s Office does not accept service by e-mail communication unless a written request is made and written approval is given.  Acceptable electronic formats include a CD, DVD or flash drive. 

These materials should be sent to:

Washington Attorney General's Office
Medicaid Fraud Control Unit
2425 Bristol Court
Olympia, WA 98502