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Date: Wednesday, July 16, 1997 FOR IMMEDIATE RELEASE Contact: Judy Holtz (202) 619-0893, Ben St. John (202) 619-1343
"For the past four years, one of our key goals has been to run Medicare and other HHS programs in a more business-like and consumer-oriented way," Secretary Shalala said. "This is an important new step toward better service and better management."
With today's action, each caller to the toll-free Hotline during operating hours will be speaking directly with a Hotline representative, instead of relying on taped messages. "This will boost the potency of the Hotline as an effective weapon in our arsenal to combat fraud and abuse in Medicare, Medicaid, and other department programs," Shalala said.
The toll-free Hotline number is 1-800-HHS-TIPS (1-800-447-8477). The TTY number for the hearing impaired is 1-800-377-4950 and the fax number is 1-800-223-8164. The Hotline is located and staffed within the Office of Inspector General (OIG) and will operate from 8 a.m. to 5:30 p.m., eastern time, Monday through Friday, with both English- and Spanish-speaking representatives available to provide assistance.
"Medicare beneficiaries are the first line of defense in combating fraud and abuse in the health care programs," Inspector General June Gibbs Brown said. "The redesigned Hotline will make it easier and quicker for them to report suspected wrongdoing."
While HHS has had a Hotline since 1979, calls were processed electronically and callers were asked to leave a recorded message until two years ago. In 1995, as part of Operation Restore Trust, a two-year anti-fraud demonstration project undertaken in Florida, Texas, New York, California and Illinois, the Hotline was modified so callers in those states could directly reach a Hotline representative.
During the two-year project, the Hotline received more than 40,000 calls, of which 14,000 were complaints that warranted follow-up action. So far, about 3,200 have resulted in identifying more than $6.2 million owed the Medicare Trust Fund, according to Inspector General Brown. More than $4.2 million of that amount was a direct result of complaints from beneficiaries or their relatives. The success of the Hotline during Operation Restore Trust as an entry point for the public to report suspected fraud and abuse provided the basis for the decision by HHS to reformat the Hotline to make it more user friendly and accessible throughout the country.
"As we learned from Operation Restore Trust, our beneficiaries and honest health care providers can be some of our most important allies in fighting fraud," said Bruce Vladeck, administrator of the Health Care Financing Administration, which includes the Medicare and Medicaid program. "In addition, we are taking many other steps to combat fraud and abuse in Medicare and Medicaid, including the Medicare Integrity Program, a system of payment safeguards which identifies and investigates suspicious claims."
During its two-year demonstration phase, Operation Restore Trust identified almost $188 million owed to the federal government, a return of more than $23 for every $1 spent on the project. As a joint project of the Inspector General, HCFA and HHS' Administration on Aging, Operation Restore Trust used new techniques to target areas Medicare and Medicaid where higher levels of fraud and abuse exist.
Secretary Shalala announced earlier this year that Operation Restore Trust techniques are now being adopted throughout the Medicare system as part of the administration's broadening attack on fraud and abuse in health care. President Clinton announced a number of other new initiatives March 25. Total HHS spending for anti-fraud, waste and abuse efforts in Medicare and Medicaid is $599 million in FY 1997, up from $452 million five years earlier.
"The Hotline is a vital part of our efforts to fight waste, fraud and abuse, but more comprehensive efforts are also needed," Inspector General Brown said. "Last March, for example, President Clinton proposed legislation to strengthen the provider enrollment process, bar felons from the Medicare and Medicaid programs, add new sanctions for fraudulent activities, and close loopholes that can allow fraud and abuse to occur. If passed by Congress, these measures would greatly strengthen our ability to combat fraud."
Callers to the Hotline are not required to identify themselves, and if they do not want to speak to a Hotline representative, they can mail or fax their complaint to the Hotline. The mailing address is: Office of Inspector General, Department of Health and Human Services, HHS-TIPS Hot Line, P.O. Box 23489, Washington, D.C. 20026. The E-mail address is htips@os.dhhs.gov.