Doug Peterson

Nebraska Attorney General

Medicaid Fraud and Patient Abuse Complaint Form


Personal Information

Facility Provider

Other Parties Involved (if applicapble)


Other Agencies Notified

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    The information given above is true to the best of my knowledge and belief. By submitting this form, I authorize the Attorney General’s Office to use the information given in any manner which is determined necessary. I understand that the Attorney General's Office is not my private attorney, but represents the State in enforcing laws designed to protect Nebraska’s Medicaid program from fraud and to protect the residents of Medicaid-funded facilities from abuse, neglect or exploitation.

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