The Office of Inspector General (“OIG”) recently launched a new, redesigned hotline webpage to better guide the public through the tip and complaint reporting process. The OIG hotline operations accepts tips and complaints from all sources regarding potential fraud, waste, abuse, and mismanagement in the U.S. Department of Health and Human Services’ (“HHS”) programs. The OIG receives nearly 115,000 complaints each year. Much of this information, as reported in the OIG’s promotional video, has led to thousands of referrals for further action. Therefore, the OIG stated it is imperative that users understand the complaint and submission process, which it hopes the updated webpage will help facilitate. The OIG’s updated hotline webpage creates a more user friendly environment and a better experience for the complainants.
On the new website, users can find guided questions, mobile compatibility, and more information regarding the types of complaints that the OIG investigates. The updated hotline page includes a section titled “What You Need to Know.” This section contains a link to information for the complainant to review before they submit a complaint. The information on found at this link includes a list of the types of claims the OIG investigates and a list of complaints not addressed through the OIG hotline. The new hotline website lists the following as the types of complaints it investigates: (1) Complaints for HHS employees, grantees or contractors about fraud, waste, abuse or mismanagement in HHS programs (whistleblower complaints); (2) crime, gross misconduct, or conflicts of interest involving HHS employees, grantees or contractors; (3) fraud, waste, or abuse relating to HHS grants or contracts; (4) false or fraudulent claims submitted to Medicare or Medicaid; (5) kickbacks or inducements for referrals by Medicare or Medicaid providers; (6) medical identity theft involving Medicare and/or Medicaid beneficiaries; (7) failure of a hospital to evaluate and stabilize an emergency patient; (8) abuse or neglect in nursing homes and other long-term-care facilities; and (9) human trafficking by HHS employees, contractors or grantees to include procuring a commercial sex act. There is also information regarding what is needed for the complaint, privacy safe guards, what to expect after a complaint is submitted, and how to appeal an OIG hotline operations complaint decision.
In addition to submitting a complaint online, complainants may also forward their tip via phone or mail, as indicated on the updated website. However, the OIG notes in its promotional video, that online complaint submission is preferred because of the efficiency. It also allows individuals the opportunity to submit supporting documents, along with their complaints. Supporting documents cannot be submitted via the other types of complaint submissions.
The OIG emphasized the importance of the updated Hotline website, by stating that the new site will provide complainants with much more information than they previously had available to them. The updated site will guide complainants in filing complaints that the OIG can act on. The OIG stressed that, while they are not able to provide complainants with a status on their tip or complaint, the complainants’ role is very important, and the OIG would be unable to stamp out fraud, waste, and abuse without their assistance.
Given the OIG’s focus on increasing the simplicity in allowing the public to notify it about potential fraud and abuse issues, we will not be surprised if there is a quick and significant increase in the number of complaints filed. This, in turn, could lead to increased investigatory activity by the OIG. We will continue to provide updates as the OIG publishes information about its updated hotline.