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. ATTORNEY'S OFFICE
U.S. Department of Justice
Washington, D.C. 20530-0001
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
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
(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
If the State surveyors from the licensing division do not
properly address your complaint, you can ask CMS's Beneficiary Protection 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.