Do you or someone you know have questions and concerns about Medicare? If your purpose in filing a complaint is to gain some type of relief—such as obtaining a refund from a Medicare-participating provider or qualifying for benefits from an HHS-funded program HHS strongly advises pursuing other administrative or judicial remedies. OIG rarely intervenes in personal or civil grievances. If you need other types of help, however, the following contacts at the Department of Health and Human Services may offer answers to questions or other assistance:
Issues about Medicare policy, coverage, billing claims or appeals, Lost or stolen Medicare card. File a complaint at Medicare.gov or call 1-800-MEDICARE
Allegations by HHS employees of discrimination on the basis of race, gender, ethnicity, religion or sexual preference. Contact your agency’s Equal Employment Opportunity officer
Allegations by employees or applicants concerning prohibited personnel practices; or Hatch Act violations. Contact the U.S. Office of Special Counsel
- Appeals of administrative decisions made by HHS agencies, grantees or contractors, including Medicare payment decisions and contract or grant awards. Consult the guidelines for the particular program
- Appeals of judicial decisions by federal or state courts involving HHS programs. Contact the court that issued the decision
- Complaints of failure to safeguard medical information, i.e. HIPAA violations. Contact HHS Office for Civil Rights
- Customer service complaints involving HHS employees, grantees or contractors. Contact the Management of the relevant agency
- Fraud relating to Social Security. Contact Social Security Administration OIG
- Allegations of identity theft unrelated to HHS programs. Contact Federal Trade Commission
- Disability fraud. Report it to Social Security Administration OIG
- SNAP/Food Stamp Fraud. Report it to USDA OIG
- Self-Disclosures. Review the Self-Disclosure information
Before contacting the agencies, it’s a good idea to collect all relevant information available to you. Sharing more accurate and comprehensive information improves the chance that you’ll get the information or other assistance you need and reduce delays. At minimum, you should e prepared to share the following:
- Name and contact information of the individual or business related to your complaint. This includes, if available, addresses, telephone numbers, e-mail addresses, etc.
- Narrative explaining the nature, scope, time frame and how you came to learn about the activity in question.
- The name and contact information of any individual who can help corroborate the information you are reporting.
- Supporting evidence in electronic format that can be uploaded with your report. This may include e-mail communications, documents, billing records or photographs.
More Information
For additional information about the requirements or concerns discussed in this article, republication or other related matters, please contact the author, employment lawyer Cynthia Marcotte Stamer via e-mail, via telephone at (214) 452 -8297 or on LinkedIn.
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About the Author
Recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: Erisa & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, Cynthia Marcotte Stamer is a practicing attorney board certified in labor and employment law by the Texas Board of Legal Specialization and management consultant, author, public policy advocate and lecturer widely known for management work, coaching, teachings, and publications.
Ms. Stamer also shares her thought leadership, experience and advocacy on these and other concerns by her service as a practicing attorney, as well as as an industry, policy management consultant, and policy strategist as well through her leadership participation in professional and civic organizations. Examples of her many leadership involvements include service as the Vice President and Executive Director of the North Texas Healthcare Compliance Association; Executive Director of the Coalition on Responsible Health Policy and its PROJECT COPE: Coalition on Patient Empowerment; Vice Chair of the ABA International Law Section Life Sciences and Health Committee; Vice Chair of the ABA Tort & Insurance Practice Section Medicine and Law Committee and former Vice Chair of its Employee Benefits Committee and its Worker’s Compensation Commitee; Past Chair of the ABA Health Law Section Managed Care & Insurance Section; ABA Real Property Probate and Trust (RPTE) Section former Employee Benefits Group Chair, current Welfare Committee Co-Chair and past RPTE Representative to ABA Joint Committee on Employee Benefits Council Representative, and Defined Contribution Committee Co-Chair, past Welfare Benefit Committee Chair and current Employee Benefits Group Fiduciary Responsibility Committee Co-Chair, Substantive and Group Committee member, Membership Committee member and RPTE Representative to the ABA Health Law Coordinating Council; past Chair of the Dallas Bar Association Employee Benefits & Executive Compensation Committee; a former member of the Board of Directors, Treasurer, Member and Continuing Education Chair of the Southwest Benefits Association; former Board President of the early childhood development intervention agency, The Richardson Development Center for Children; former Gulf Coast TEGE Council Exempt Organization Coordinator; a founding Board Member and past President of the Alliance for Healthcare Excellence; former board member and Vice President of the Managed Care Association; past Board Member and Board Compliance Committee Chair for the National Kidney Foundation of North Texas; a member and policy adviser to the National Physicians’ Council for Healthcare Policy and others.
Ms. Stamer also is a widely published author, highly popular lecturer, and serial symposia chair, who publishes and speaks extensively on human resources, labor and employment, employee benefits, compensation, occupational safety and health, and other leadership, performance, regulatory and operational risk management, public policy and community service concerns for the American Bar Association, ALI-ABA, American Health Lawyers, Society of Human Resources Professionals, the Southwest Benefits Association, the Society of Employee Benefits Administrators, the American Law Institute, Lexis-Nexis, Atlantic Information Services, The Bureau of National Affairs (BNA), InsuranceThoughtLeaders.com, Benefits Magazine, Employee Benefit News, Texas CEO Magazine, HealthLeaders, the HCCA, ISSA, HIMSS, Modern Healthcare, Managed Healthcare, Institute of Internal Auditors, Society of CPAs, Business Insurance, Employee Benefits News, World At Work, Benefits Magazine, the Wall Street Journal, the Dallas Morning News, the Dallas Business Journal, the Houston Business Journal, and many other symposia and publications. She also has served as an Editorial Advisory Board Member for human resources, employee benefit and other management focused publications of BNA, HR.com, Employee Benefit News, InsuranceThoughtLeadership.com and many other prominent publications and speaks and conducts training for a broad range of professional organizations and for clients on the Advisory Boards of InsuranceThoughtLeadership.com, HR.com, Employee Benefit News, and many other publications.
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