Medicare Blog

what happens when hhs-oig hotline pursues a medicare beneficiary complaint

by Dr. Haleigh Roberts II Published 2 years ago Updated 1 year ago

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.

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.

What does the HHS OIG Hotline do?

HHS-OIG Hotline Operations accepts tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement in HHS programs. HHS-OIG maintains a list of fugitives wanted for health care fraud, abuse or child support obligations.

What should I not send to OIG Hotline?

If you choose to file your complaint via the mail and include documents supporting your allegation, do not send original documents, as they will not be returned. Do not mail any of the following items to OIG Hotline: Digital media, including flash drives, iPads, disks, etc. used medical supplies, diagnostic equipment or research devices

What happens during an IG investigation?

The OIG reviews the information and makes an initial determination of what action is required. If an allegation appears to be credible, the OIG will generally take one of three actions: (1) initiate an investigation; (2) initiate an audit or inspection; or (3) refer the allegation to management or another agency.

What does OIG HHS do?

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 complaints does OIG address?

Complaints we investigate include:Complaints from HHS employees, grantees or contractors about fraud, waste, abuse or mismanagement in HHS programs (whistleblower complaints),Crime, gross misconduct, or conflicts of interest involving HHS employees, grantees or contractors,More items...

How do I file a complaint with HHS OIG?

In addition to submitting your complaint online, you may also forward your tip via one of the channels below:Phone. 1-800-HHS-TIPS (1-800-447-8477)TTY. 1-800-377-4950.Mail. U.S. Department of Health and Human Services. Office of Inspector General. ... Fax. 1-800-223-8164.

What is a Medicare OIG audit?

Under this authority, OIG conducts audits of internal CMS activities, as well as activities performed by CMS grantees and contractors. These audits are intended to provide independent assessments of CMS programs and operations and to help promote economy and efficiency.

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.

Are OIG reports anonymous?

Information reported to the Office of the Inspector General is confidential.

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.

Are Inspector General reports anonymous?

The DoD Inspector General determines the disclosure is unavoidable during the course of the investigation. ANONYMOUS FILING STATUS: If you file your complaint anonymously, we will not know who you are, and we will not be able to contact you to request additional information.

Who investigates false claims?

The Attorney General works to protect the state against fraud and other financial misconduct through the enforcement of the California False Claims Act.

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