Please complete this form to report patient or resident abuse, neglect, or exploitation, as well as attempts to commit fraud against the Kentucky Medicaid Program. Your report provides the Office of the Attorney General the information we need to investigate and, when appropriate, prosecute those who seek to harm our most vulnerable citizens. You may choose to make a complaint anonymously by selecting “Yes” to the question below regarding confidentiality. If you chose to do so, your name and contact information will ONLY be used by our staff if we require additional information to investigate your complaint.
First Name: is required
Last Name: is required
Phone Number: is required
Would you like to report patient abuse, Medicaid fraud, or both? is required
Last four digits of Social Security Number: is invalid
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