FAQ for Fraud Reporting

What can you report?

Suspected fraud can be reported for any potential wrongdoing by a client, provider, contractor, or State of Georgia employee related to any DECAL program.

Why should I report suspected fraud?

Submitting fraudulent information to the state or federal government for financial gain is against the law. Most providers work hard and are honest in reporting information to DECAL. It is unfair to honest providers when some of your colleagues are not honest and transparent in their reporting. Also, the funds that DECAL distributes come from state and federal tax dollars paid by all of us. Claiming those funds for work that has not been done is illegal and is just wrong. If you saw or suspected any other illegal act (e.g., robbery, assault, hit and run, etc.), you would report it. Reporting suspected financial fraud is no different. Sharing information is crucial in stopping fraud and enhancing program integrity.

How do I report suspected Fraud?

There are three ways to report: (1) Online reporting form (preferred method) (2) Email ReportFraud@decal.ga.gov (3) Call 877-88-GATIP (877-884-2847)

When should I report suspected fraud?

Immediately. It is best to report suspected fraud once you became aware of it.

If I do not have all the information to corroborate my suspicions, should I still report it?

Yes, report it. Try to obtain as much complete information as possible to the best of your abilities.

What information should be included in the report?

Share as much information as you can. If you have any supporting information, you may upload the documents when completing the form. However, supporting documentation is not required.

Can I upload more than one document?

Yes, the form will allow you to upload more than one document.

What should not be reported?

Only acts related to potential fraud in DECAL programs are reviewed. You should not report general policy violations or complaints about a program. If you need to report violations, make a complaint, or request general information about a DECAL program, contact the appropriate division: https://www.decal.ga.gov/Bfts/ContactList.aspx

What happens after I submit my report?

The decision to follow-up on a report through an investigation, audit, or review rests exclusively with DECAL. DECAL will not provide you with status updates or action taken on an allegation.

Will someone at DECAL contact me regarding my report?

Generally, we will contact you only if we need additional information or clarification.

Can I report internally at DECAL?

Yes. How much information you give is up to you, but submitting valid contact information can help if we need more information from you.

What is fraud?

“Fraud” is any activity that relies on deception in order to achieve a gain. Fraud involves obtaining something of value through willful misrepresentation. (Association of Certified Fraud Examiners, ACFE)

Here are some examples of activities that are high risks for fraud violations:

  • Lying on an application;
  • Submitting a false claim that a provider uses to receive payment for a service;
  • Submitting a claim for a service that did not occur;
  • Billing for a longer period of time than was actually spent delivering the service;
  • Billing for a service that really was not needed;
  • Taking or giving bribes, which could be money or gifts, so the provider will get more business or other favors;
  • Paying someone so they will give you more business or individuals to serve;
  • Submitting a claim with inadequate or poor documentation to support the service that was billed;
  • Making up a record to pretend that a service was provided, even though it was not;
  • Making up a report or altering a document to pretend that the expense was incurred, even though it was not; or
  • Alteration or falsification of documents.

What is program integrity?

The term “program integrity” encompasses the concept that programs should be organizationally and structurally sound and capable of achieving their mission without compromise. It is the umbrella under which payment integrity, internal controls, fraud risk management, and improper payments prevention fall. (The Anti-Fraud Playbook, Chief Financial Officers, CFO)

What is DECAL’s responsibility?

DECAL strives to safeguard the integrity of all DECAL programs from risk internally and externally. We continuously work to develop and maintain governance structures, controls, and processes to protect resources and assets.