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To report fraudulent practices by hospices in your area,
contact the U.S. Department of Health and Human Services - Office
of Inspector General "Fraud Hotline" at its website for
a direct e-mail link (see below) or call Tel. No. 1-800-447-8477
(800-HHS-TIPS). You can also call the regional office for your
area (see below). We recommend that you put your complaint in
writing, including specific information about the nature of your
complaint, with dates and names, and then mail it by
certified/return receipt U.S. mail to the regional office that
covers your area.
You should also contact your local U.S. Attorney's Office (part of the
U.S. Dept. of Justice) to report violations of the law and fraud.
Putting an end to health care fraud and hospice fraud is a
responsibility of all U.S. citizens.
We do not recommend reporting fraud to your State's
Department of Public Health or "Bureau of Health
Systems." If your hospice care is paid for by private
commercial insurance, HMO or managed care, then report fraud to
your private insurance company's fraud department and your
State's Attorney General's office. State Health Dept.
agencies are appropriate for reporting violations of standards of
care, but the U.S. government agencies listed below are the
appropriate agencies to notify when healthcare fraud occurs and
Medicare or Medicaid is involved.
When any hospice or other agency signs on patients and bills
Medicare, Medicaid, or private insurers without providing full
service to the patients, families/caregivers, and the bereaved,
fraud is occurring. If a hospice bills you directly for hospice
services related to the terminal illness, even though the patient
has coverage under Medicare, Medicaid or private insurance,
fraudulent double-billing may be occurring. Don't be
exploited. Report it. Help stop hospice fraud!
The greatest enemy of quality hospice care, and hospice in
general, are "rogue" hospices and their
"clever" administrators, who operate for their own
enrichment and violate the very mission of hospice. In addition,
the system for reimbursement of hospices may itself be partially
responsible for creating circumstances that lead to fraud and/or
financial difficulties for some hospices.
Rogue hospices may be some of the well-established and large
hospices; they may routinely have long articles about their
hospice services in the newspapers, praising the wonderful
services they provide to the dying. These rogue hospices violate
the rights of numerous patients, violate the spirit of hospice,
and thereby, they give hospice a bad "word of mouth"
reputation which rarely gets explored in the news media. And
those hospices which run an honest operation struggle to get
coverage in the media for their excellent work.
Please take into consideration that large hospices pay large
amounts for advertising in the press, and so newspapers reward
them with wonderful reviews (one hand wipes the other).
Fortunately, there are many hospices which provide excellent
care, and without a doubt, the hospice staff you will encounter
are mostly extremely dedicated to the hospice mission.
- U.S. DEPT. OF HEALTH AND HUMAN SERVICES
OFFICE OF INSPECTOR GENERAL'S FRAUD HOTLINE
http://oig.hhs.gov/hotline.html
Although you can directly e-mail a complaint to the Office of
Inspector General from their website (linked above) or e-mail
them at: HHSTips@oig.hhs.gov or call them at: 1-800-HHS-TIPS
(1-800-447-8477), or fax at: 1-800-223-8164 we recommend that you write a hard copy
letter and send it to one of the following local/regional
offices. Writing to the national office will result in a
much slower response time and it may take several months for them
to get back to you. You will get a faster response if you call
your regional Office of Investigations of the Office of Inspector
General. For your convenience we list the regional phone numbers
here:
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Boston - MA, VT, NH, ME, RI, CT 617-565-2660
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New York - NY, NJ, PR, VI 212-264-1691
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Philadelphia - PA, MD, DE, WV, VA, DC 215-861-4586
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Atlanta - GA, KY, NC, SC, FL, TN, AL, MS 404-562-7603
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Chicago - IL, MN, WI, MI, IN, OH, IA, MO 312-353-2740
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Dallas - TX, NM, OK, AR, LA, CO, UT, WY, MT, ND, SD, NE,
KS 214-767-8406
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Los Angeles - AZ, NV, So. CA 714-246-8302
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San Francisco - No. CA, AK, HI, OR, ID, WA 415-975-4570
We recommend that you call these regional offices and
get the direct mailing address and name of the special agent
there with whom you speak. Then, always put your complaint in
writing. You may wish to use the complaint form provided here at Hospice Patients
Alliance.
U.S. ATTORNEY'S OFFICE
www.usdoj.gov/02organizations/02_1.html
U.S. Department of Justice
Washington, D.C. 20530-0001
We include a listing of local U.S. Attorney's Offices for your
convenience. It is wise to send a complaint to the U.S.
Attorney's office when you are certain that health care fraud
or a wrongful death has occurred. For example, if a patient was
given medications which the patient had refused to take, and was
given a medication which may have been intended to cause death
before the patient would have naturally died, an involuntary
death or involuntary euthanasia may have occurred (plainly
speaking "murder".
These serious violations of patient rights need to be
investigated by professional criminal investigators. Just because
a patient is terminally ill does not give any physician, nurse or
health care agency the right to put someone to death using
medications against the patient's will. If you have any
questions, you can call the U.S. Attorney and set up an
appointment to meet with them. You can also find the local U.S.
attorney's office in your city directory under the category
of: "United States Government - United States
Attorney."
HEALTH CARE FINANCING ADMINISTRATION (HCFA)
DIVISION OF PROGRAM INTEGRITY
www.hcfa.gov/medicare/fraud
(If you put a complaint in to your State's Dept. of
Public Health/Bureau of Health Systems (or other name in your
State), and do not get a satisfactory response, write to
HCFA's regional office which covers your area and ask them to
review the matter.
Sometimes there are "political connections" between
the State licensing agency and the local hospice...and these
"political connections" may interfere with the proper
investigation of the hospice. (It is reported that some States
may protect certain hospices with the "right
connections!")
If the State surveyors from the licensing division do not
properly address your complaint, you can ask HCFA to reconsider
your complaint. HCFA supervises the State licensing and
certification offices which respond to your complaints. HCFA is
committed to making sure that every tax dollar spent by Medicare
for hospice services goes for actual services provided.)
HCFA's offices are set up as ten regional offices covering
the entire United States. We recommend that you make a complaint
in writing!
You can use the complaint form provided by Hospice Patients Alliance if
you wish. Telephoning a complaint about a State
inspection to HCFA is not an effective way to resolve a problem.
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Region I HCFA offices cover: Connecticut, Maine,
Massachusetts, New Hampshire, Rhode Island, and Vermont.
Region I HCFA offices are located at:
Health Care Financing Administration - Region I
[Your State's Name here] - Operations Branch
Division of Medicaid and State Operations
John F. Kennedy Federal Building, Room 2275
Boston, Massachusetts 02203
Tel: 617-565-1299 Fax: 617-565-4835
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Region II HCFA offices cover: New York, New Jersey, and Puerto
Rico
Region II HCFA offices are located at:
Health Care Financing Administration - Region II
[Your State's Name here] - Operations Branch
Division of Medicaid and State Operations
26 Federal Plaza, Room 3804
New York, NY 10278
Tel: 212-264-1121 Fax: 212-264-6814
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Region III HCFA offices cover: Delaware; Washington, D.C.;
Maryland, Pennsylvania, Virginia and West Virginia
Region III HCFA offices are located at:
Health Care Financing Administration - Region III
[Your State's Name here] - Operations Branch
Division of Medicaid and State Operations
3535 Market Street, 3rd Floor, Rm. 3100
Philadelphia, PA 19104
Tel: 215-596-6574 Fax: 215-596-1351
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Region IV HCFA offices cover: Alabama, Florida, Georgia,
Kentucky, Mississippi, South Carolina, Tennessee, and North
Carolina
Region IV HCFA offices are located at:
Health Care Financing Administration - Region IV
[Your State's Name here] - Operations Branch
Division of Medicaid and State Operations
101 Marietta Tower, Suite 701
Atlanta, Georgia 30323
Tel: 404-331-2214 Fax: 404-331-0104
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Region V HCFA offices cover: Illinois, Indiana, Michigan,
Minnesota, Ohio, and Wisconsin
Region V HCFA offices are located at:
Health Care Financing Administration - Region V
[Your State's Name here] - Operation's Branch
Division of Medicaid and State Operations
105 West Adams Street. 14th Floor
Chicago, IL 60603
"Tel: 312-353-8850 Fax: 312-353-3419
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Region VI HCFA offices cover: Arkansas, Louisiana, New Mexico,
Oklahoma, and Texas
Region VI HCFA offices are located at:
Health Care Financing Administration - Region VI
[Your State's Name here] - Operations Branch
Division of Medicaid and State Operations
1200 Main Tower Bldg. HCF-2, Room 1940
Dallas, TX 75202
Tel: 214-767-6301 Fax: 214-767-0270
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Region VII HCFA offices cover: Iowas, Kansas, Missouri and
Nebraska
Region VII HCFA offices are located at:
Health Care Financing Administration - Region VII
[Your State's Name here] - Operation's Branch
Division of Medicaid and State Operations
New Federal Office Building
601 East 12th St., Rm. 242
Kansas City, MO 64106
Tel: 816-426-2011 Fax: 816-426-6769
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Region VIII HCFA offices cover: Colorado, Montana, North
Dakota, South Dakota, Utah and Wyoming
Region VIII HCFA offices are located at:
Health Care Financing Administration - Region VIII
[Your State's Name here] - Operation's Branch
Division of Medicaid and State Operations
Federal Office Building
1961 Stout Street, Rm. 574
Denver, CO 80294-3538
Tel: 303-844-4024 Fax: 303-844-3753
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Region IX HCFA offices cover: Arizona, California, Hawaii and
Nevada
Region IX HCFA offices are located at:
Health Care Financing Administration - Region IX
[Your State's Name here] - Operation's Branch
Division of Medicaid and State Operations
75 Hawthorne Street, 4th & 5th Floors
San Francisco, CA 94105
Tel: 415-744-3696 Fax: 415-744-2692
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Region X HCFA offices cover: Alaska, Idaho, Oregon and
Washington State
Region X HCFA offices are located at:
Health Care Financing Administration - Region X
[Your State's Name here] - Operations Branch
Division of Medicaid and State Operations
2201 - 6th Avenue
Blanchard Plaza Bldg., 8th Floor
Seattle, WA 98121
Tel: 206-615-2308 Fax: 206-615-2435
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