Waste, Fraud, & Abuse - FAQs:

How do I report fraud, waste or abuse of Medicare?

To report suspected Medicare fraud, call toll free 1-800-HHS-TIPS (1-800-447-8477).

HHS has joined with the Department of Justice and AARP to launch a national initiative against fraud, waste, and abuse in the Medicare program. The campaign,"Who Pays? You Pay," is aimed at both waste and at criminal fraud and abuse against the Medicare program.

Learn More:

Medicare Fraud Overview (Medicare.gov)

stopmedicarefraud.gov

How do I report identity theft?

You can call the Federal Trade Commission (FTC) at 1-877-438-4338 or online at http://www.ftc.gov/bcp/edu/microsites/idtheft/ to report identity theft.

Do I have to identify myself if I report fraud to the Inspector General?

The OIG Hotline takes all allegations of fraud and abuse seriously. Providing your identity and contact information, however, could facilitate any subsequent investigation, as the agency assigned to review your complaint may have additional questions. OIG will exercise due caution to protect your identity, but we can provide no guarantees of this.

If you choose to remain anonymous, the best method to transmit your complaint would be via regular mail:

Office of the Inspector General
HHS TIPS Hotline
P.O. Box 23489
Washington, DC 20026

How do I report disability fraud?

You can call the Social Security Administration (SSA) Office of Inspector General Hotline at 1-800-269-0271 or online at http://www.ssa.gov/oig to report disability fraud.

When should I call the Inspector General's Hotline on waste, fraud, and abuse?

You should contact the Office of the Inspector General (OIG) Hotline to report fraud and abuse in the programs and initiatives administered by the Department of Health and Human Services. The Hotline screens all submissions to determine whether the situation falls under the jurisdiction of the OIG and whether there is sufficient information to pursue the matter further.

The Hotline is not the proper venue to complain about Department policy. Similarly, the Hotline is not able to provide information about Department programs, comment on OIG activity, or offer judgments on hypothetical situations.

What happens when I report fraud to the Inspector General's Hotline?

If the Hotline determines that your complaint of fraud and abuse merits further scrutiny, it will refer the complaint to appropriate field agency for review and development. That agency will then decide how to proceed with the complaint.

We cannot provide information regarding what action we have taken on any allegation reported to our office. Federal regulations prohibit the disclosure of information contained in law enforcement records even to the individual making the allegation. The complaint resolution process usually takes at least six months.

What is the mission of the Office of the Inspector General Hotline?

The Inspector General Hotline is designed to receive and process complaints of possible fraud, waste and abuse in programs administered by the department.

All HHS and contractor employees have a responsibility to assist in combating fraud, waste and abuse in all departmental programs. Matters involving fraud, waste and mismanagement in any departmental program(s) should be reported to the Office of the Inspector General (OIG). The Hotline offers a confidential means for reporting vital information.

How can I report fraud, waste, and abuse about an HHS program?

Complaints of possible fraud, waste, and abuse can be reported to the Inspector General's Hotline. There are several ways to contact the Hotline:

Toll-free phone: 1-800-HHS-TIPS (1-800-447-8477), 8:00 am - 5:30 pm, Eastern Time, Monday-Friday
Fax: 1-800-223-8164 (10 pages or less, please)
TTY: 1-800-377-4950
E-mail: hhstips@oig.hhs.gov
Mail: HHS TIPS Hotline
P.O. Box 23489
Washington, DC 20026
(Note: please do not send any original documents)

You can also access the OIG Hotline guide for filing a complaint by going to the OIG Web site at http://oig.hhs.gov/fraud/hotline/.

For security reasons, the Inspector General staff cannot offer a face-to-face interview.

What information do I need to provide when submitting a complaint to the Office of Inspector General Hotline?

Please provide the following information. If you would like your referral to be submitted anonymously please indicate in your email or phone call (1-800-447-8477) that you wish to remain anonymous.

This is the information needed for all complaints:

Your Name
Your Street Address
Your City/County
Your State
Your Zip Code
Your Email Address
Subject/Person/Business/Department that allegation is against:
1. Name of Subject
2. Title of Subject (if applicable)
3. Subject's Street Address
4. Subject's City/County
5. Subject's State
6. Subject's Zip Code
Please provide a brief summary relating to your allegation.

My Medicare Summary Notice shows a charge for a service that I did not receive. Is this fraud?

You should check your Medicare Summary Notices carefully to verify that you received the services that Medicare paid for. If you do not recognize a particular service that does not necessarily mean that fraud has been committed. For example, it is possible that you received the service, but the provider name or service description is unfamiliar.

If you identify an erroneous charge on your Medicare Summary Notice, you should call the number listed in the Customer Service Box in order to speak with the Medicare-contracted insurance company that processed the claim. A representative will be able to access your records via computer, and may be able to determine immediately whether the service charge represents a billing error, a misunderstanding on your part, or a potential instance of fraud.

If you are unable to reach the Medicare contractor, or if so advised by the contractor representative, you may also report the charge to the Inspector General's Hotline at 1-800-HHS-TIPS (1-800-447-8477).

See more Frequently Asked Questions about Medicare fraud, waste, and abuse at: http://questions.medicare.gov/app/answers/list