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Recent Compliance Updates & Tips

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Results Show Nearly 70,000 “Tips” to the Hotline

The HHS OIG is mandated to provide a semi-annual report to Congress to summarize its activities. This report included a section on the OIG Hotline (1-800-HHS-TIPS), available to individuals to report fraud, waste, or abuse in HHS programs. The OIG considers its Hotline a significant avenue of intelligence for the OIG, and is worth taking the time to understand. What it also underscores is that many more “whistleblowers” contact the OIG directly than file qui tam actions with the DOJ. The reported statistics tell this story. During the first half of 2017, the OIG Hotline had 66,891 contacts. A “contact” is the total number of instances when an individual contacted the OIG Hotline Operations, regardless of the nature of the contact, and receives service through automated or manual means. Of that number, 14,562 contacts underwent evaluation, with 9,970 referred for further action and the remaining 4,222 closed administratively. The sources of the tips that were referred for action varied. Those received via the Hotline phone amounted to 5,127. The internet was the source for 3,768, with the remaining 1,075 coming from letters and facsimiles. All complaints submitted to the Hotline are evaluated to determine whether an issue rises to the level of a complaint and whether it falls within the OIG’s jurisdiction. The OIG forwarded approximately one-third of complaints to its field offices for follow-up, and slightly less than half of them to CMS, with the remaining balance referred to other HHS operating divisions and federal agencies.

Jillian Bower is a highly experienced health care compliance consultant who has assisted scores of clients with their hotline operations through the Compliance Resource Center (CRC). She notes that having an effective ethics hotline program is a must for any effective compliance program; however, many organizations have hotlines that are not effective. Those not promoting an effective hotline operation are making a grave error and risk driving complainants externally to the DOJ and OIG, litigating attorneys, the media, etc. which can only spell trouble. Receiving and resolving issues internally is the right approach and is good for the organization on many levels. On the other hand, failing to do so can result in potential liabilities, headaches, and a lot of remedial work.  Maintaining a positive culture for employees to report problems, concerns, and perceived wrongdoing will encourage internal reporting rather than individuals resorting to “whistleblowing” to external parties.

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Compliance Hotline Best Practice Tips

  1. Develop and implement written guidelines relating to the hotline operation that contain information on (a) hotline operations, (b) duty to report, (c) non-retaliation, (d) anonymity, (e) confidentiality, and (f) investigation of complaints, among others.
  2. Have information about the use of the hotline made part of the Employee Handbook and Code of Conduct.
  3. Promote a culture that encourages employees to raise concerns and report perceived problems with managers, reminding them that these are opportunities for improvement in the organization.
  4. Maintain a confidential recordkeeping system to enable a review of employment history for those employees who have raised concerns or reported problems.
  5. Have posters on employee bulletin boards regarding the availability and use of the hotline.
  6. Ensure that the hotline number and its availability are addressed in new employee orientation.
  7. Consider disseminating a flyer to all employees on the availability of the hotline.
  8. If there is an Intranet for employee use, include information about the hotline.
  9. If there is an organizational newsletter, use it to promote the hotline.
  10. Take extra care to avoid doing anything that might be interpreted as retaliatory.
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