Hospice Patients Alliance: Consumer Advocacy


LINKS TO REPORT FRAUD AND CRIMES

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

    www.oig.hhs.gov/fraud/hotline/

    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 and addresses below. You can also get information on how to report fraud at Medicare's "How to Report Fraud" webpage.




  • Boston/Region I - CT, ME, MA, NH, RI, VT
    Phone................: 617-565-1340
    Postal address.: U.S. DEPT. OF HEALTH AND HUMAN SERVICES, OFFICE OF INSPECTOR GENERAL REGION I OFFICE, Government Center, J.F.Kennedy Federal Building, Boston, MA 02203
    Web site............: www.hhs.gov/region1



  • New York/Region II - NY, NJ, Puerto Rico, Virgin Islands
    Phone................: 212-264-3313
    Postal address.: U.S. DEPT. OF HEALTH AND HUMAN SERVICES, OFFICE OF INSPECTOR GENERAL REGION II OFFICE, Jacob Javits Federal Bldg, 26 Federal Plaza, New York, NY 10278
    Web site............: www.hhs.gov/region2



  • Philadelphia/Region III - DE, DC, MD, PA, VA, WV
    Phone................: 215-861-4441
    Postal address.: U.S. DEPT. OF HEALTH AND HUMAN SERVICES, OFFICE OF INSPECTOR GENERAL REGION III OFFICE, 150 S. Independence Mall West, Public Ledger Bldg, Philadelphia, PA 19106-9111
    Web site............: www.hhs.gov/region3



  • Atlanta/Region IV -- AL, FL, GA, KY, MS, NC, SC, TN
    Phone................: 404-562-7886
    Postal address.: U.S. DEPT. OF HEALTH AND HUMAN SERVICES, OFFICE OF INSPECTOR GENERAL REGION IV OFFICE, Sam Nunn Atlanta Federal Center, 61 Forsyth St., S.W., Atlanta, GA 30303-8909
    Web site............: www.hhs.gov/region4


    Note: for Miami -  305-530-7756   X500


  • Chicago/Region V - IL, IN, MI, MN, OH, WI
    Phone................: 312-886-2359
    Postal address.: U.S. DEPT. OF HEALTH AND HUMAN SERVICES, OFFICE OF INSPECTOR GENERAL REGION V OFFICE, 233 N. Michigan Ave., Chicago, IL 60601
    Web site............: www.hhs.gov/region5



  • Dallas/Region VI - AR, LA, NM, OK, TX
    Phone................: 214-767-4056
    Postal address.: U.S. DEPT. OF HEALTH AND HUMAN SERVICES, OFFICE OF INSPECTOR GENERAL REGION VI OFFICE, Earle Cabell Building, 1100 Commerce St., Dallas, TX 75202
    Web site............: www.hhs.gov/region6



  • Kansas City/Region VII -- IA, KS, MO, NE
    Phone................: 816-426-7278
    Postal address.: U.S. DEPT. OF HEALTH AND HUMAN SERVICES, OFFICE OF INSPECTOR GENERAL REGION VII OFFICE, 601 East 12 St., Kansas City, MO 64106
    Web site............: www.hhs.gov/region7



  • Denver/Region VIII -- CO, MT, ND, SD, UT, WY
    Phone................: 303-844-2024
    Postal address.: U.S. DEPT. OF HEALTH AND HUMAN SERVICES, OFFICE OF INSPECTOR GENERAL REGION VIII OFFICE, 1961 Stout St., Denver, CO 80294-3538
    Web site............: www.hhs.gov/region8



  • San Francisco/Region IX -- American Samoa, AZ, CA, Guam, HI, NV
    Phone................: 415-437-8310
    Postal address.: U.S. DEPT. OF HEALTH AND HUMAN SERVICES, OFFICE OF INSPECTOR GENERAL REGION IX OFFICE, 50 United Nations Plaza, San Francisco, CA 94102
    Web site............: www.hhs.gov/region9



  • Seattle/Region X  - AK, ID, OR, WA Phone................: 206-615-2287
    Postal address.: U.S. DEPT. OF HEALTH AND HUMAN SERVICES, OFFICE OF INSPECTOR GENERAL REGION X OFFICE, 2201 Sixth Ave., Seattle, WA 98121-1831
    Web site............: www.hhs.gov/region10




    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."




  • CENTERS FOR MEDICARE SERVICES
    BENEFICIARY COMPLAINT RESPONSE PROGRAM

    www.cms.hhs.gov/BeneComplaintRespProg/

    (If you put a complaint in to your State's Dept. of Public Health/Bureau of Health Systems (or other name in your State) about a quality-of-care issue, and do not get a satisfactory response, write to the Centers for Medicare " Medicaid's regional office which covers your area and ask them to review the matter. You can learn much from the Centers for Medicare Services government website.

    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 CMS's Beneficiary Complaint Response Program to reconsider your complaint. CMS supervises the State licensing and certification offices which respond to your complaints. CMS is committed to making sure that every tax dollar spent by Medicare for hospice services goes for actual services provided.)

    You can use the complaint form provided by Hospice Patients Alliance if you wish. Telephoning a complaint about a State inspection to CMS is not an effective way to resolve a problem.





Back To Main Links Page





Search This Site


  About Us   | Disclaimer | Donations | Euthanasia Issues | FAQS

  Find Hospice | Find MD Consult | Find Nurse Consult | Guide to Hospice

Help   | Home | Hospice News Center | Hospice Regulations | Newsletter |   Privacy Policy

HPA is a nonprofit, charitable 501(c)(3) patient advocacy organization





All material copyright of Hospice Patients Alliance ("HPA") unless otherwise credited.