Kusserow on Compliance: OIG report on 2017 Hotline activity

The HHS Office of Inspector Genera (OIG) is mandated to provide a semiannual report to Congress to summarize its activities. Included in this report was 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 the hotline a significant avenue of intelligence. What it also underscores is that many more “Whistleblowers” contact the OIG directly, than by filing qui tam actions with the DOJ. During the second half of 2017 alone, the OIG Hotline received 58,110 hotline contacts which were evaluated to determine whether an issue rises to the level of a complaint and whether it falls within OIG’s jurisdiction. Of that 13,781 were sufficient in details to warrant evaluation. The hotline phone was the source for 5,815 of these cases with another 3,966 obtained via the OIG website.  In addition 1,107 complaints were obtained via letter or fax. After evaluation, 10,888 were referred for action. The balance did not provide basis for further action or were found to not provide evidence of violations. The source of those tips that were referred for action varied.  Those received via the hotline phone were 5,127.  The internet was the source for 3,768 tips with the remaining 1,075 tips coming from letters and facsimiles.

The OIG forwarded approximately one-third of the complaints to its field offices for follow-up, slightly less than half to CMS, with the balance referred to other HHS operating divisions and other federal agencies. During this semiannual reporting period, the OIG Hotline reported expected recoveries of $9.9 million as a direct result of cases originating from hotline complaints.

Jillian Bower, has assisted scores of clients with their hotline operations through the Compliance Resource Center (CRC). She notes that having an effective hotline program is a must for any effective compliance program, however many organizations with 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, media, etc. and that can only spell trouble. Receiving and resolving issues internally is the right approach and is good for the organization on many levels. Failing to do so can result in potential liabilities, headaches, and a lot of remedial work. By maintaining such a positive culture for employees to be able to report problems, concerns, and perceived wrongdoing will encourage internal reporting rather than having individuals thinking they must resort to “whistleblowing” to external parties.

10 Practical Tips

  1. Develop and implement written guidelines relating to the hotline operation that should information on the (a) hotline operations, (b) duty to report, (c) non-retaliation, (d) anonymity, (e) confidentiality, (f) investigations 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 being counseled 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 the employee bulletin boards for the availability and use of the hotline.
  6. Ensure the hotline number and its availability is included in new employee orientation.
  7. Consider having a flyer go out 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 organization newsletter, use it to promote the hotline.
  10. Extra care needs to be taken to avoid doing anything that might be interpreted as retaliatory.

 

Richard P. Kusserow served as DHHS Inspector General for 11 years. He currently is CEO of Strategic Management Services, LLC (SM), a firm that has assisted more than 3,000 organizations and entities with compliance related matters. The SM sister company, CRC, provides a wide range of compliance tools including sanction-screening.

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Copyright © 2017 Strategic Management Services, LLC. Published with permission.