Before You Submit a Complaint
HHS-OIG's Hotline reviews and investigates thousands of complaints each year. Before you begin, make sure you have the following information available:
- Type of complaint
- HHS program being affected by your allegation
- Your name and contact information
- Name and contact information of the person, business, department that the allegation is against
- Narrative explaining the nature, scope, and time frame of the activity in question
If your purpose in filing a complaint is 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.
An OIG analyst will review your complaint for relevance and completeness. Not all complaints result in an investigation.
If you have identified yourself, a reviewing official may contact you for further information.
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 OIG does not provide the status of complaints. You 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.
- Complaints from HHS employees, grantees or contractors about fraud, waste, abuse or mismanagement in HHS programs (whistleblower complaints),
- Crime, gross misconduct, or conflicts of interest involving HHS employees, grantees or contractors,
- Fraud, waste, or abuse relating to HHS grants or contracts,
- False or fraudulent claims submitted to Medicare or Medicaid,
- Kickbacks or inducements for referrals by Medicare or Medicaid providers,
- Medical identity theft involving Medicare and/or Medicaid beneficiaries,
- Failure of a hospital to evaluate and stabilize an emergency patient,
- Abuse or neglect in nursing homes and other long-term-care facilities.
- Human Trafficking by HHS employees, contractors or grantees to include procuring a commercial sex act
For some types of complaints, you need to contact a different office.
Complaint Who to Contact
Issues about Medicare policy, coverage, billing claims or appeals
Lost or stolen Medicare card
Allegations by HHS employees of discrimination on the basis of race, gender, ethnicity, religion or sexual preference
Your agency's Equal Employment Opportunity officer
Allegations by employees or applicants concerning prohibited personnel practices; or Hatch Act violations
Appeals of administrative decisions made by HHS agencies, grantees or contractors, including Medicare payment decisions and contract or grant awards
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
Customer service complaints involving HHS employees, grantees or contractors
Management of the relevant agency
Fraud relating to Social Security
Allegations of identity theft unrelated to HHS programs
SNAP/Food Stamp Fraud
You may provide your complaint anonymously. However, the lack of contact information prevents a comprehensive review of the complaint and will prevent further communication between you and HHS-OIG. Read more about privacy safeguards.