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Hotline Operations FAQ

What is HHS OIG Hotline Operations?

The Inspector General Act of 1978 gave the OIG the authority to accept complaints from HHS employees and the general public concerning criminal activity, fraud, waste, abuse and mismanagement of HHS programs and operations. OIG Hotline Operations is a component of the OIG, Office of Investigations, overseeing several hotlines through which complaints and information are received. OIG Hotline Operations reviews and processes complaints which may or may not result in an investigation, audit, or inspections performed by the OIG, or administrative action by an Operating Division of Staff Division of HHS. As a result, the OIG Hotline helps ensure the proper and efficient use of taxpayer dollars and Government resources for the American people.

What types of common complaints can I report?

Most complaints fall in the following categories:
  • Crime, gross misconduct, or conflicts of interest involving HHS employees/contractors,
  • Fraud, waste, or abuse relating to HHS Grants/Contracts, including American Recovery and Reinvestment Act (ARRA) grants,
  • False/Fraudulent claims submitted to Medicare/Medicaid,
  • Kickbacks/inducements for referrals by Medicare/Medicaid providers,
  • Medical Identity Theft involving Medicare and/or Medicaid Beneficiaries,
  • Failure of a hospital to evaluate and stabilize an emergency patient,
  • Abuse/neglect in nursing homes and other long term care facilities.

What Types of Common Complaints are NOT Accepted by OIG?

Common complaints not addressed through the OIG Hotline include:
  • 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),
  • Allegations by employees or applicants concerning prohibited personnel practices; non-ARRA whistleblower retaliation; or Hatch Act violations (please contact the US Office of Special Counsel),
  • 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),
  • Appeals of judicial decisions by Federal or state courts involving HHS programs (please contact the court that issued the decision),
  • Complaints of failure to safeguard medical information, i.e. HIPAA violations (please contact the HHS Office for Civil Rights),
  • Customer service complaints involving HHS employees/contractors (please contact management of the relevant agency),
  • Fraud relating to Social Security (please contact the Social Security Administration OIG),
  • Allegations of identity theft unrelated to HHS programs (please Contact the Federal Trade Commission).
Please, DO NOT SEND any of the following items to the OIG Hotline:
  • used medical supplies, diagnostic equipment or research devices
  • used personal care products
  • medical waste (including sharps such as needles/lances)
  • biological products or clinical specimens
See U.S. Postal Service Domestic Mail Manual 610.8 (Non-mailable & 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 non-mailable items is a crime punishable by fine, imprisonment or both.

Do I Need to Identify Myself?

No, you do not have to identify yourself. A complainant may remain anonymous (i.e., unknown even to HHS/OIG). If the complainant chooses to remain anonymous, HHS/OIG cannot obtain additional information on the allegation (e.g., testimonial or documentary evidence; identity of witnesses. All complaints submitted to OIG Hotline Operations 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. 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.

The Inspector General Act (IG Act) protects an employee of HHS. The IG Act prevents disclosure of an HHS employee’s identity outside HHS/OIG unless the Office of Inspector General, on rare occasions, determines that release of the complainant's identity is essential to investigate the allegation. To avoid disclosure, the confidential employee complainant should provide a contact address and telephone number off HHS facility premises.

While HHS/OIG cannot force any complainant to reveal their identity, HHS/OIG may not be able to investigate certain complaints without a disclosure or release of identity.

Whistleblower Protection
: OIG Hotline Operations will provide anyone protected under Federal whistle blower statutes the protections required under law.

What Should I Include in My Complaint?

Complaints should include sufficient information for OIG to determine whether the complaint warrants review or investigation by the OIG, such as:
  • The identity of the wrongdoer(s) and victim(s).
  • The alleged legal or policy violation(s) or other misconduct.
  • The effect of the wrongdoing, such as dollars lost, delay produced, etc.
  • The date(s) when the event(s) occurred.
  • The identity of any witness(es) to the event(s).
  • Whether anyone else has already reviewed the allegation.
  • An address and telephone number of a named complainant (If not wishing to remain anonymous).
  • A complete narrative: Your comments need not be exhaustive but should include sufficient detail for a basic analysis of the complaint and include an explanation of the nature, scope, and time frame of the activity and if 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 — Items submitted will not be returned.)
  • If you are reporting a suspicious charge from a Medicare Summary Notice, please include a copy of the Notice.

What Happens After I File My Complaint?

OIG Hotline Operations logs all complaints. An OIG analyst will review your complaint for relevance and completeness. Not all complaints result in an investigation, and OIG Hotline Operations may take one of the following actions with respect to complaints received:
  1. Take No Further Action. OIG Hotline Operations administratively close the complaint, taking no further action on matters which are not within HHS or OIG's jurisdiction, are outside referral criteria identified by HHS and OIG management, or are too trivial, stale, or vague to warrant further review. For example, anonymous complaints that lack sufficient information are too vague to warrant further review. Whenever possible, OIG will attempt to refer the complaint to the appropriate authorities.
  2. Make an Administrative Referral. OIG Hotline Operations will refer certain matters directly to the appropriate HHS or non-HHS facility or office if the allegation appears to warrant some action on that facility's or office's part. For example, an allegation of serious misconduct involving another Federal or state agency will be sent to that agency for appropriate action. For HHS matters, non-case referrals are made for complaints that do not rise to the level of an investigative referral, but OIG believes some HHS action appears necessary.
  3. Make a Hotline Complaint Referral. OIG Hotline Operations will refer matters for further review for serious allegations of criminal activity, fraud, waste, abuse, and mismanagement. The nature of the allegations will determine whether OIG will refer the case to another OIG component or make an external referral to a non-OIG facility or office. Hotline cases are assigned a complaint number using an internal numbering system.
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.

What Are the Privacy Safeguards Concerning Hotline Complaints?

OIG Hotline Operations complaints are official records covered by the Privacy Act, 5 U.S.C. §552a. OIG Hotline Operations complaint referrals are provided to non-OIG offices for review and response on an official-need-to-know basis only, and must not be released to the subjects of complaints. Although additional information may be received during the course of a complaint such items are part of the OIG Hotline file, and its release is subject to OIG approval.

Can You Obtain a Status and/or Results of an OIG Hotline Operation complaint?

Due to privacy and identity concerns, OIG Hotline Operations cannot respond to requests for status of complaints, including whether complaints and written materials have been received. Since status requests received by OIG Hotline Operations take staff time and resources away from processing and resolving complaints, OIG requests that complainants and others refrain from making such requests.

We understand the natural inclination to follow up on a report but OIG Hotline Operations does not provide the status or results of complaints. Complainants have the option, however, of requesting records through the OIG Freedom of Information Act 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.

Can You Appeal an OIG Hotline Operations Complaint Decision?

There are no appeal rights to a decision by OIG Hotline Operations as to the actions taken on a particular complaint. OIG Hotline Operations is not a statutory entity, court, or other administrative body. The IG Act gives the Inspector General sole discretion regarding the processing and investigation of hotline complaints.
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Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201