In the Office of Investigations, we investigate allegations of fraud, waste, or abuse affecting programs administered by the U.S. Office of Personnel Management (OPM). We operate a fraud hotline whereby individuals can report allegations directly to the Office of the Inspector General (OIG). Both the American taxpayers and Federal employees are harmed when OPM programs are defrauded or when misconduct compromises program integrity. We pursue criminal prosecution, civil action, and/or administrative penalties when appropriate. We frequently investigate cases jointly with the Department of Justice (DOJ) and other Federal, state, and local law enforcement agencies. Our investigations are nationwide, so our criminal investigators and analysts are located in small offices across the country, in addition to our office in Washington, DC.
Our investigations include:
- Federal Employees Health Benefits Program (FEHBP), which is the world's largest employer-sponsored group health insurance program and insures approximately eight million people: The Office of Investigations handles cases related to false claims submitted by both FEHBP participants and health care providers; instances of pharmaceutical fraud or drug diversion; and fraud committed by insurance carriers.
- Civil Service Retirement System (CSRS) and the Federal Employees Retirement System (FERS): We investigate cases involving improper retirement payments made to deceased annuitants or survivors; theft or diversion of annuity payments; and embezzlement from the Civil Service Retirement and Disability Fund.
- Federal Investigative Service (FIS): The Office of Investigations pursues cases related to the personnel security and suitability program operated by FIS, which performs approximately 90% of the background investigations for the Federal Government. Our investigations have involved false statements in and fabrication of background investigation reports.
- We also conduct investigation of OPM employee and contractor misconduct.
Concerned citizens, OPM employees, OPM program offices, and OPM contractors report suspected fraud, waste, and abuse to the OIG. We also use data analysis techniques to identify potential fraud in high risk programs, and we participate in health care fraud task forces across the country. When appropriate, we refer health care providers the OIG's Debarring Official for possible suspension or debarment from the FEHBP.
ALERT! Don't be a victim of medical identity theft. Protect your insurance policy number as you would your credit card information and review your medical bills and explanation of benefits statements.