The HHS Office of Inspector General has reviewed the effectiveness and activity of CMS’ fraud hotline, suggesting the agency issue written guidance for processing hotline complaints and upgrade its information system, according to an OIG report.
At least one year after receiving complaints through 1-800-HHS-TIPS, 12 percent of complaints remained unresolved, according to the report. CMS has no required timeframe within which contractors should resolve complaints. For instance, contractors began work on a 58 percent of complaints within 30 days of receipt. For 29 percent of complaints, however, contractors took more than four months to begin review.
Along with firmer guidelines regarding the timeframe of complaint resolution, the OIG recommends CMS ensure its information system tracks user activity on each complaint and sends out alerts when a complaint has not been assigned to a contractor.
Read the OIG report on CMS’ fraud complaint hotline.
Read more about government agencies and healthcare fraud:
– CMS Discusses Focus to Prevent “Bad Actors” From Participation in Medicare, Medicaid
– CMS Publishes Final Rule on Fraud Prevention and Regulations
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