Does HHS OIG investigate Medicare frauds?
HHS-OIG has encountered a variety of scams in which fraudsters are preying upon people across the U.S., including Medicare and Medicaid beneficiaries. Criminal, civil or administrative legal actions relating to fraud and other alleged violations of law, initiated or investigated by HHS-OIG and its law enforcement partners.
How many complaints does OIG review each year?
HHS-OIG’s Hotline reviews and investigates thousands of complaints each year. We recommend you review Before You Submit a Complaint to understand the type of complaints we do and do not investigate and the complaint process.
How do I file a complaint with HHS OIG?
HHS-OIG’s Hotline reviews and investigates thousands of complaints each year. We recommend you review Before You Submit a Complaint to understand the type of complaints we do and do not investigate and the complaint process. Start your online complaint with HHS-OIG by selecting an option below.
What is the Office of OIG Hotline operations?
OIG Hotline Operations accepts tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement in the U.S. Department of Health and Human Services’ programs. HHS-OIG has encountered a variety of scams in which fraudsters are preying upon people across the U.S., including Medicare and Medicaid beneficiaries.
What is OIG in Medicare?
Since its 1976 establishment, the Office of Inspector General (OIG) has been at the forefront of the Nation's efforts to fight waste, fraud and abuse and to improving the efficiency of Medicare, Medicaid and more than 100 other Department of Health & Human Services (HHS) programs.
What is the OIG SNF compliance guidance?
OIG has developed a series of voluntary compliance program guidance documents directed at various segments of the health care industry, such as hospitals, nursing homes, third-party billers, and durable medical equipment suppliers, to encourage the development and use of internal controls to monitor adherence to ...
How do I file a complaint with HHS OIG?
HHS-OIG can only accept unclassified complaints online For instructions on filing a tip on a CLASSIFIED matter, call 1-800-447-8477.
What is the HHS OIG and what is its major concern?
OIG is an independent and objective organization that fights fraud, waste, and abuse and promotes efficiency, economy, and effectiveness in HHS programs and operations. We work to ensure that Federal dollars are used appropriately and that HHS programs well serve the people who depend on them.
What are the seven OIG elements of an effective compliance plan?
They are as follows:Designation of a compliance officer and compliance committee. ... 2. Development of compliance policies and procedures, including standards of conduct. ... Developing open lines of communication. ... Appropriate training and education. ... Internal monitoring and auditing. ... Response to detected deficiencies.More items...•
How do I ensure Medicare compliance?
Seven steps to complianceDevelop standards of conduct. ... Establish a method of oversight. ... Conduct staff training. ... Create lines of communication. ... Perform auditing and monitoring functions. ... Enforce standards and apply discipline. ... Respond appropriately to detected offenses.
What happens when OIG investigation?
Q: What happens when an investigation is complete? A: Generally, when an investigation is complete, OIG will produce a report based upon relevant witness interviews, records, and other evidence. The report will be reviewed within OIG to ensure that it is fact-based, objective, and clear.
What does OIG do?
According to the Inspector General Act of 1978, as amended, the Inspector General's mission is to: Conduct independent and objective audits and investigations relating to DHS programs and operations. Promote economy, efficiency, and effectiveness in DHS programs and operations.
What is OIG exclusion list?
Exclusions. The Office of Inspector General's List of Excluded Individuals/Entities (LEIE) provides information to the health care industry, patients and the public regarding individuals and entities currently excluded from participation in Medicare, Medicaid, and all other Federal health care programs.
What are the 3 statutory goals of an OIG?
OIG provides independent and objective oversight that promotes economy, efficiency, and effectiveness in the programs and operations of HHS.
What is the OIG looking at?
Investigating Fraud, Waste and Abuse. Facilitating Compliance in the Health Care Industry. Excluding Bad Actors from Participation in Federal Health Care Programs.
What does the OIG monitor?
OIG monitors and tracks the use of taxpayer dollars through audits, inspections, evaluations, and investigations. The Inspector General keeps the Secretary of Commerce and Congress fully and currently informed about problems and deficiencies relating to Commerce's activities and the need for corrective action.
What is OIG hotline?
OIG Hotline Operations accepts tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement in the U.S. Department of Health and Human Services’ programs.
What is the HHS OIG?
HHS-OIG has a long history of protecting the health and well-being of HHS beneficiaries, including residents in long-term care facilities such as nursing homes. HHS-OIG collects and investigates tips and complaints about fraud, waste, and abuse in these facilities.
What is OIG compliance?
OIG's compliance documents include special fraud alerts, advisory bulletins, podcasts, videos, brochures, and papers providing guidance on compliance with Federal health care program standards. OIG also issues advisory opinions, which cover the application of the Federal anti-kickback statute and OIG's other fraud and abuse authorities to ...
What is OIG in healthcare?
To help healthcare providers such as hospitals and physicians comply with relevant Federal health care laws and regulations, OIG creates compliance resources, which are often tailored to particular providers.
What is the OIG?
The Office of Inspector General (OIG) for the U.S. Department of Health & Human Services has created the educational materials to assist in teaching physicians about the Federal laws designed to protect the Medicare and Medicaid programs and program beneficiaries from fraud, waste, and abuse.
What does the Inspector General do?
The Inspector General occasionally issues letters to health care providers alerting them to OIG policies and processes; inviting them to engage in our anti-fraud initiatives; and updating them on our ongoing projects to fight fraud, waste, and abuse in Federal health programs.
What is the OIG hotline?
The Office of Inspector General (OIG) Hotline is a resource for Federal employees and the public to report allegations of employee corruption, civil rights and civil liberties abuses, program fraud and financial crimes, and miscellaneous criminal and non-criminal activity associated with waste, abuse or fraud affecting the programs and operations of the U.S. Department of Homeland Security (DHS).
What should be reported to the OIG hotline?
The Allegations that should be reported to the OIG Hotline include, but are not limited to: Employee corruption, civil rights and civil liberties abuses, program fraud and financial crimes, and miscellaneous criminal and non-criminal activity associated with waste, abuse, mismanagement or misconduct affecting the programs and operations of the U.S. Department of Homeland Security (DHS).
How to report FEMA disaster relief?
You can file a report online by accessing the DHS OIG Online Allegation Form. Automated filing of the DHS OIG Online Allegation form will ensure that your allegation is expeditiously received by the OIG.
What to do if you believe you are a victim of whistleblower retaliation?
If you believe you are a victim of whistleblower retaliation, please contact the OIG Hotline or the Office of Special Counsel for more information by accessing the Whistleblower Resources.
Why is it necessary for the OIG to disclose a confidential complainant's identity?
It may be necessary for the OIG to reveal a confidential complainant's identity if such identification is necessary to investigate the alleged matter, or as otherwise required by law. Complainants who file anonymously, or those requesting confidentiality, should understand filing as such may hinder the OIG's ability to thoroughly pursue their complaint. Anonymity may be forfeited when submitting an online allegation to the DHS OIG Hotline
What information do you provide to a DHS employee?
If the alleged offender is a DHS employee, please provide the employee's name, title, tour of duty, and the name and address of the DHS agency where the employee works. Additionally, the information you provide should be as detailed as possible.
What is the OIG?
The OIG relies upon concerned employees and citizens to provide us with information regarding alleged employee corruption, waste, fraud, mismanagement or misconduct within DHS. Although not required to do so, we urge you to identify yourself when submitting an allegation using the automated DHS OIG Online Allegation form
What is the OIG hotline?
The OIG makes a determination whether an issue rises to the level of a complaint and whether it falls within the OIG’s jurisdiction. For issues that fall outside the OIG’s jurisdiction or that do not rise to the level of a complaint, the OIG provide individuals contacting the OIG Hotline with, whenever possible, another avenue to seek assistance, such as calling their State health and human services agencies or 1-800-MEDICARE. For example, if callers inquire about terminology on a Medicare Summary Notice, they will be referred to call 1-800-MEDICARE. If callers have complaints involving Medicaid eligibility, the caller is referred to call their State Medicaid agencies. In contrast, if a caller alleges that a Medicare beneficiary was billed for services not received, it is logged as a complaint.
What is the OIG report?
On June 1, 2015, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its “Semiannual Report to Congress October 1, 2014-March 31, 2015.” The OIG is mandated to provide a semiannual report to Congress that summarizes their activities from the past fiscal year. Included in this report was a section on the OIG Hotline (1-800-HHS-TIPS), available to individuals to provide information that may assist in combating fraud, waste, or abuse in HHS programs (e.g., Medicare, Medicaid, child support enforcement and Head Start).
What is the purpose of the OIG grant fraud?
Grant Fraud. The OIG may use the information you provide to investigate violations of civil or criminal law or regulation. The OIG is authorized to collect this information pursuant to the Inspector General Act of 1978 as amended, 5 U.S.C. App. 3.
What is an EEO complaint?
EEO complaints. Misconduct by judges at the federal, state, or local level. Misconduct by state and local police departments (unless the misconduct concerns DOJ grant funds) Misconduct at state and local prisons (unless the complainant involves a U.S. Marshals Service detainee) You may report waste, fraud, abuse, ...
Where to report waste, fraud, abuse, or misconduct relating to a DOJ employee, program, contract,?
You may report waste, fraud, abuse, or misconduct relating to a DOJ employee, program, contract, or grant to the OIG Hotline . The OIG accepts complaints related to the following DOJ components:
What is the Federal Bureau of Investigation?
the Federal Bureau of Investigation; Drug Enforcement Administration; Federal Bureau of Prisons; U.S. Marshals Service; Bureau of Alcohol, Tobacco, Firearms, and Explosives; United States Attorneys Offices; and. Employees who work in other Divisions or Offices in the Department of Justice, with the one exception of allegations ...
Where to file a complaint against the Department of Justice?
Please visit IGNET at https://www.ignet.gov/ for a listing of other federal Offices of Inspectors General.
Who has jurisdiction to investigate whistleblower retaliation?
The DOJ OIG also has jurisdiction to investigate allegations of whistleblower retaliation involving: Employees of the Federal Bureau of Investigation. Employees of DOJ contractors, subcontractors, grantees, and subgrantees.
Do you have to provide identity to OIG?
Individuals who report allegations are not required to provide their identity to the OIG. However, persons who report allegations are encouraged to identify themselves to help the OIG evaluate and investigate the complaints.