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How Do I Report Suspected Fraud?

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How Do I Report Suspected Fraud?

One of the most important tools in helping prevent fraud is the reporting of suspected fraudulent activities by concerned employees or beneficiaries. The OIG maintains a hotline as a confidential means for reporting suspected fraud. If you suspect fraud, please contact the OIG using any of the following options:

Phone: 800-HHS-TIPS (800-447-8477)
Fax: 800-223-8164 (limit to ten pages please)
Email: HHSTips@oig.hhs.gov

Mailing address:

U.S. Department of Health and Human Services
Office of Inspector General
ATTN: OIG HOTLINE OPERATIONS
P.O. Box 23489
Washington, DC 20026

If you are attempting to report specific information proving Medicare fraud, please provide as much identifying information as possible. This may include the suspected individual’s name, address and phone number, as well as any other details regarding the allegation.

Look for additional information from CMS on the OIG Hotline Operations web page.

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Department of Health and Human Services OIG

The Department of Health and Human Services OIG has developed A Roadmap for New Physicians: Avoiding Medicare and Medicaid Fraud and Abuse. The Roadmap summarizes the five main federal fraud and abuse laws (the False Claims Act, the Anti-Kickback Statute, the Stark Law, the Exclusion Statute and the Civil Monetary Penalties Law) and provides tips on how physicians should comply with these laws in their relationships with payers (like the Medicare and Medicaid Programs), relationships with vendors (like drug, biologic and medical device companies), and relationships with fellow providers (like hospitals, nursing homes and physician colleagues).

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CMS Fraud Prevention Tools

CMS produced two fraud prevention training modules currently available on the Medscape website. These modules provide key information to health care practitioners and professionals on how they can assist CMS in preventing fraud and abuse, as well as highlight CMS’ efforts to fight fraud and abuse and explain how health care professionals can be part of these efforts.

A total of 1.25 hours of CME credits can be earned for any Medscape user registered as a doctor or health care professional. Medscape accounts are free, and users do not have to be health care professionals to register for them. Register for a free Medscape account.

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Instructions for Accessing the Medscape Modules

  • Step 1: Go to the Medscape website. Medscape accounts are free of charge.
  • Step 2: Registration is on the upper right-hand corner of the Medscape home page next to the log in field.
  • Step 3: To access the modules, first enter your membership log in information.

Revised 10/15/2021