Report Fraud | Office of Inspector General | U.S. Department of Health and Human Services

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name="skipNav"></a> <div id="mainBody"> <div id="leftSideInterior"> <div id="breadcrumbs"> <ul> <li> <a href="/web/20130508165430/https://oig.hhs.gov/">Home</a> </li> <li> <a href="/web/20130508165430/https://oig.hhs.gov/fraud">Fraud</a> </li> <li> Report Fraud </li> </ul> </div> <div id="leftContentInterior"> <h1>Report Fraud</h1> <p> The OIG Hotline accepts tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement in Department of Health and Human Services' programs. Your information will be reviewed promptly by a professional staff member. Due to the high volume of information that we receive, we are unable to reply to submissions; however, we appreciate the information that you have provided. </p> <p>To report <strong>Disability Fraud</strong>, visit <a style="color:#A21F0D" class="exit" href="https://web.archive.org/web/20130508165430/https://www.socialsecurity.gov/fraudreport/oig/public_fraud_reporting/form.htm"><strong>Social Security Administration, OIG</strong></a></p> <p>To report <strong>SNAP/Food Stamp Fraud</strong> visit <a style="color:#A21F0D" class="exit" href="https://web.archive.org/web/20130508165430/http://www.fns.usda.gov/snap/fraud/fraud_4.htm"><strong>USDA, OIG</strong></a></p> <table> <tr> <td valign="top"> <a target="_self" href="https://web.archive.org/web/20130508165430/https://forms.oig.hhs.gov/hotline/report-fraud-form.aspx" class="reportNow"><span>report fraud now</span></a> </td> <td> <p class="reportNow"> or you may also forward your tip to one of the following: </p> </td> </tr> <tr> <td colspan="2">   </td> </tr> </table> <div class="featuredContent" style="position:relative;">  <p class="r" style="width:auto;"><strong>Mail:</strong><br/> US Department of Health and Human Services<br/> Office of Inspector General<br/> ATTN: OIG HOTLINE OPERATIONS<br/> PO Box 23489<br/> Washington, DC 20026 </p> <p><strong>Phone:</strong><br/> 1-800-HHS-TIPS (1-800-447-8477) </p> <p><strong><span class="red">*</span>Fax:</strong><br/> 1-800-223-8164 </p> <p><strong>TTY:</strong><br/> 1-800-377-4950 </p> <img class="whistle" src="/web/20130508165430im_/https://oig.hhs.gov/images/whistleStandAlone.png" alt="whistle image"/> <div class="clear"></div> </div> <p class="i"><span class="red">*Note:</span> While you may remain anonymous, in order to accept submissions for review via facsimile, the OIG Hotline requires a complaint to include a formal cover letter or the use of the downloadable complaint submission form, available in <a target="_blank" href="./hotline_complaint_submission_form.pdf">PDF</a> or <a target="_blank" href="./hotline_complaint_submission_form.docx">DOCX</a> versions.</p> <p class="i">OIG Hotline Operations does not accept facsimile submissions over 45 pages. Such submissions should be submitted via the internet complaint page where the uploading of larger documents is available.</p> <p class="i">OIG Hotline Operations processes complaints in electronic format and does not maintain, or return, original documentation or items received as part of a complaint.</p> <p>All HHS and contract employees have a responsibility to assist in combating fraud, waste, and abuse in all departmental programs. As such, you are encouraged to report matters involving fraud, waste and mismanagement in any HHS program(s) to the Hotline. <img class="cleanPdf" src="/web/20130508165430im_/https://oig.hhs.gov/images/icon_pdf.gif" alt="pdficon"/> <a target="_blank" class="clean" href="/web/20130508165430/https://oig.hhs.gov/fraud/report-fraud/OIG_Hotline_Poster.pdf">Download the Contractor Code of Ethics and Business Conduct Poster</a></p> <h2 class="acc_trigger"><a href="#">Please, DO NOT SEND any of the following items to the OIG Hotline:</a></h2> <div class="acc_container"> <div class="block"> <ul> <li>used medical supplies, diagnostic equipment or research devices</li> <li>used personal care products</li> <li>medical waste (including sharps such as needles/lances)</li> <li>biological products or clinical specimens </li> </ul> <p>See U.S. Postal Service Domestic Mail Manual 610.8 (Nonmailable & Restricted Articles) & 10 (Hazardous Materials). Details with supporting information may be included in narrative form as part of the OIG Hotline complaint. A violation of 18 U.S.C. § 1716 governing nonmailable items is a crime punishable by fine, imprisonment or both.</p> </div> </div>  <h2 class="acc_trigger"><a href="#">What categories of tips can I report?</a></h2> <div class="acc_container"> <div class="block"> <p>Most complaints fall in the following categories:</p> <ul> <li>Crime, gross misconduct, or conflicts of interest involving HHS employees/contractors,</li> <li>Fraud, waste, or abuse relating to HHS Grants/Contracts, including American Recovery and Reinvestment Act (ARRA) grants,</li> <li>False/Fraudulent claims submitted to Medicare/Medicaid, </li> <li>Kickbacks/inducements for referrals by Medicare/Medicaid providers, </li> <li>Medical Identity Theft involving Medicare and/or Medicaid Beneficiaries, </li> <li>Failure of a hospital to evaluate and stabilize an emergency patient, </li> <li>Abuse/neglect in nursing homes and other long term care facilities, </li> </ul> <p>Complaints not addressed through the OIG Hotline include:</p> <ul> <li>Allegations by HHS employees of discrimination on the basis of race, gender, ethnicity, religion or sexual preference (please contact your agency's Equal Employment Opportunity officer), </li> <li>Allegations by employees or applicants concerning prohibited personnel practices; non-ARRA whistleblower retaliation; or Hatch Act violations (please contact the <a class="exit" href="https://web.archive.org/web/20130508165430/http://www.osc.gov/">US Office of Special Counsel</a> ),</li> <li>Appeals of administrative decisions made by HHS agencies/contractors, including Medicare payment decisions and contract/grant awards (please consult the guidelines for the particular program), </li> <li>Appeals of judicial decisions by Federal or state courts involving HHS programs (please <a class="exit" href="https://web.archive.org/web/20130508165430/http://www.hhs.gov/ocr/">contact the court that issued the decision</a> ), </li> <li>Complaints of failure to safeguard medical information, i.e. HIPAA violations (please <a class="exit" href="https://web.archive.org/web/20130508165430/http://www.hhs.gov/ocr/">contact the HHS Office for Civil Rights</a> ), </li> <li>Customer service complaints involving HHS employees/contractors (please contact management of the relevant agency), </li> <li>Fraud relating to Social Security (please <a class="exit" href="https://web.archive.org/web/20130508165430/http://oig.ssa.gov/report-fraud-waste-or-abuse">contact the Social Security Administration OIG</a> ), </li> <li>Allegations of identity theft unrelated to HHS programs (please <a class="exit" href="https://web.archive.org/web/20130508165430/http://www.ftc.gov/bcp/edu/microsites/idtheft/">Contact the Federal Trade Commission</a> ),</li> </ul> </div> </div>  <h2 class="acc_trigger"><a href="#">Do I need to identify myself?</a></h2> <div class="acc_container"> <div class="block"> <p>No, you do not have to identify yourself. All complaints submitted to the Hotline are treated confidentially. Complaints are shared only within HHS for the purpose of evaluating your complaint; public disclosure of personally identifiable information is restricted by the Privacy Act. </p> <p>If you prefer, you may provide your complaint anonymously. In many cases, however, the lack of contact information prevents a comprehensive review of the complaint and will prevent further communication between you and HHS OIG. If you wish to enter your complaint anonymously, please take care to withhold any personally identifiable information from your complaint narrative and from any attachments.</p> <p><b>Whistleblower Protection</b>: OIG Hotline Operations will provide anyone protected under Federal whistle blower statutes the protections required under law.</p> </div> </div> <h2 class="acc_trigger"><a href="#">What should I include in my complaint?</a></h2> <div class="acc_container"> <div class="block"> <p>To the best of your ability, please provide the following information when contacting the <a href="#top"> Hotline</a> </p> <p>Type of complaint:</p> <ul> <li>fraud/waste involving American Recovery and Reinvestment Act funds</li> <li>crime/misconduct/mismanagement by HHS employee/official</li> <li>contractor fraud</li> <li>grants fraud</li> <li>billing Medicare/Medicaid for services not provided</li> <li>kickbacks/inducements by healthcare providers</li> <li>failure of healthcare providers to meet business requirements for participation in Medicare/Medicaid</li> <li>direct solicitation of Medicare/Medicaid beneficiaries</li> <li>failure of a Medicare private plan to provide contracted Service</li> <li>abuse/neglect of nursing home residents</li> <li>failure to pay child support</li> <li>false application for an HHS-funded assistance program</li> <li>other (please explain in your narrative description)</li> </ul> <div class="contentSeparator"></div> <p>HHS program being affected by your allegation</p> <ul> <li>Office of the Secretary</li> <li>Centers for Medicare & Medicaid Services</li> <li>Traditional Medicare (Parts A and B)</li> <li>Medicare Advantage Plan (Part C)</li> <li>Medicare Prescription Drug Program (Part D)</li> <li>Medicaid</li> <li>Administration for Children & Families</li> <li>Temporary Assistance to Needy Families</li> <li>Head Start</li> <li>Office of Child Support Enforcement</li> <li>Indian Health Service</li> <li>National Institutes of Health (please specify which Institute in your narrative description)</li> <li>Centers for Disease Control and Prevention</li> <li>Food and Drug Administration</li> <li>Administration on Aging</li> <li>Agency for Healthcare Quality and Research</li> <li>Agency for Toxic Substances and Disease Registry</li> <li>Healthcare Resources and Services Administration</li> <li>Substance Abuse and Mental Health Services Administration</li> <li>US Public Health Service Commissioned Corps</li> <li>Other (please explain in your narrative description)</li> </ul> <div class="contentSeparator"></div> <p>Unless you choose to remain anonymous please provide the following data. If you are submitting your complaint anonymously, please take care to withhold personally identifiable information.</p> <ul> <li>Your Name</li> <li>Your Street Address</li> <li>Your City/County</li> <li>Your State</li> <li>Your Zip Code</li> <li>Your Telephone Number(s)</li> <li>Your email Address</li> </ul> <div class="contentSeparator"></div> <p>Subject/Person/Business/Department that allegation is against:</p> <ul> <li>Name of Subject</li> <li>Title of Subject (if applicable)</li> <li>Subject's Street Address</li> <li>Subject's City/County</li> <li>Subject's State</li> <li>Subject's Zip Code</li> <li>Subject's Telephone Number(s)</li> <li>Subject's email address/website</li> </ul> <div class="contentSeparator"></div> <p>Narrative: <br/> Your comments need not be exhaustive but should include sufficient detail for a basic analysis of the complaint. </p> <p> In addition to explaining the nature, scope, and time frame of the activity in question, please be sure you address the following questions (as appropriate):</p> <ul> <li>How you are aware of the alleged activity? <ul> <li>Have you already reported the fraud, waste, and/or abuse? If so, to whom?</li> <li>Have you suffered retaliation for reporting this activity? If so, explain.</li> </ul> </li> <li>Do you know of any potential witnesses to the activity?</li> <li>Do you have any documents or other physical evidence in your possession? (You may attach samples to your complaint but please do not send original documents — <span class="standout">Items submitted will not be returned to you.)</span></li> </ul> <p>If you are reporting a suspicious charge from a Medicare Summary Notice, please include a copy of the Notice.</p> </div> </div> <h2 class="acc_trigger"><a href="#">What happens after I file my complaint?</a></h2> <div class="acc_container"> <div class="block"> <p> An OIG analyst will review your complaint for relevance and completeness. Not all complaints result in an investigation. </p> <p> If you have identified yourself, a reviewing official may contact you for further information. </p> <p> The OIG Hotline is not authorized to disclose any information on records in its possession: the Hotline will not be able to confirm receipt of your complaint or respond to any inquiries about action taken on your complaint. We understand the natural inclination to follow up on a report but the OIG does not provide the status of complaints. </p> <p> You have the option, however, of requesting records through the OIG <a href="/web/20130508165430/https://oig.hhs.gov/foia/index.asp">Freedom of Information Act </a> officer. Remember to phrase your request in terms of a search for records pertinent to your complaint, not status. You should wait at least six months before filing such a request. </p> <p> If your purpose in filing a complaint is in part to gain some type of relief — such as obtaining a refund from a Medicare-participating provider or qualifying for benefits from an HHS-funded program — we strongly advise that you pursue other administrative or judicial remedies. OIG rarely intervenes in personal or civil grievances. </p> </div> </div> </div> </div>  <div id="rightSide"> <div id="imLookingForHeading"><span>I'm Looking For</span></div> <div id="imLookingFor"> <p>Let's start by choosing a topic</p> <div id="chooseTopic"> <a href="#">Select One </a> </div> </div> <div id="topicSelection"> <a href="#" id="closeButton"><span>X</span></a> <ul class="leftSide"> <li> <a href="/web/20130508165430/https://oig.hhs.gov/reports-and-publications/compendium/"> <h3>Compendium</h3> <p>Unimplemented OIG recommendations summarized.</p> </a> </li> <li> <a href="/web/20130508165430/https://oig.hhs.gov/reports-and-publications/workplan/index.asp#current"> <h3>FY 2013 Work Plan</h3> <p>OIG projects planned for 2013.</p> </a> </li> <li> <a href="/web/20130508165430/https://oig.hhs.gov/reports-and-publications/semiannual/index.asp"> <h3>Semiannual Report</h3> <p>Significant OIG activities in 6-month increments.</p> </a> </li> </ul> <ul class="leftSide"> <li> <a 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