The CMS should issue written guidance for how it resolves complaints on waste, fraud and abuse, and also upgrade the information system that processes those complaints, HHS' inspector general's office recommended in a new report (PDF).
CMS urged to issue complaint-handling guidance
Many federal inspector general's offices operate hotlines to respond to citizen and employee allegations of fraud, waste or abuse, and HHS' inspector general maintains one for people to offer complaints on its programs, including Medicare and Medicaid. At least one year after receiving complaints through the hotline, the CMS had resolved about 88% of those it received in the first six months of 2008, while 12% of complaints remained unresolved. Meanwhile, the CMS does not have requirements regarding the length of time that contractors have to resolve complaints.
“No written procedures for processing complaints exist at the level of the CMS central office; however, staff from two CMS regional offices reported developing standard operating procedures for handling complaints,” according to the report, which added that the status of complaints cannot be tracked in the CMS' information system.
For 58% of the complaints, the report noted, contractors reported starting to work within 30 days of receiving them. But for 29% of complaints, contractors took more than four months to begin their work. And included within that last group were 22% of complaints that contractors were unaware had been assigned to them.
Send us a letter