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What To Do If You Think You Have a Problem

If you are engaged in a relationship you think is problematic or have been following billing practices you now realize were wrong:

  • Immediately cease filing the problematic bills.
  • Seek knowledgeable legal counsel.
  • Determine what money you collected in error from your patients and from the Federal health care programs and report and return overpayments.
  • Unwind the problematic investment.
  • Disentangle yourself from the suspicious relationship.
  • Consider using OIG's or CMS's self-disclosure protocols.

The OIG Provider Self-Disclosure Protocol is a vehicle for physicians to voluntarily disclose self-discovered evidence of potential fraud. The protocol allows providers to work with the Government to avoid the costs and disruptions entailed in a Government-directed investigation.

Case Examples of Physician Liabilities Resolved Under the OIG Provider Self-Disclosure Protocol

  • A Minneapolis physician paid $53,400 and resolved liability for violating his Medicare assignment agreement by charging patients a yearly fee for services, some of which were covered by Medicare.
  • A Florida physician paid $100,000 and resolved liability related to referring patients to a lab owned by his brother.
  • A neurosurgery practice paid $10,000 and resolved liability for employing an individual who was excluded from participation in the Federal health care programs.

What To Do If You Have Information About Fraud and Abuse Against Federal Health Care Programs

If you have information about fraud and abuse against Federal health care programs, use the OIG Fraud Hotline to report that information to the appropriate authorities. The Hotline allows the option of reporting anonymously.

Phone: 1-800-HHS-TIPS (1-800-447-8477)
Fax: 1-800-223-8164
TTY: 1-800-377-4950
Mail: Office of Inspector GeneralDepartment of Health & Human ServicesAttn: HOTLINEP.O. Box 23489Washington, DC 20026