Contents 
Introduction ......................................................................................................... 2
 
1 | Safeguarding Public Health ............................................................................ 3
 
2 | Ensuring the Financial Integrity of HHS Programs .......................................... 5
 
3 | Improving Outcomes in Medicare and Medicaid ........................................... 8
 
4 | Protecting HHS Beneficiaries ........................................................................ 11
 
5 | Securing Data and Technology ..................................................................... 14
 
Conclusion ......................................................................................................... 16
 
Stay In Touch ..................................................................................................... 16
 
 
 
 
 
 
1   
Introduction 
Every year, the Department of Health and Human Services (HHS 
or the Department), Office of Inspector General (OIG) fulfills its 
statutory obligation to produce the Top Management and 
Performance Challenges Facing HHS.  While the Department has 
made efforts to address the challenges that we identify in this 
document, considerable opportunities exist for further progress.  
This document helps the Department fulfill its mission to enhance 
the health and well-being of all Americans by directing the 
Departments focus on the top management and performance 
challenges identified by OIG.   
OIGs website offers additional oversight resources, including all 
reports mentioned here, OIG recommendations to improve 
Department programs and reduce vulnerabilities, and the status 
of those recommendations.  
 
 
 
 
 
2   
1 | Safeguarding Public Health 
Elements of the Challenge 
  Addressing the mental health and substance use disorder crises 
  Improving maternal health  
  Strengthening emergency preparedness and response capabilities 
  Ensuring the safety, effectiveness, and availability of Food and Drug Administration-regulated products 
HHS must work to better safeguard public health, including the following key areas:   
Addressing the Mental Health and 
Substance Use Disorder Crises 
In 2021, more than 1 in 5 American adolescents had a major 
depressive episode, nearly 1 in 4 American adults experienced 
mental illness, nearly 1 in 6 Americans had a substance use 
disorder, more than 48,000 Americans died by suicide, and 
more than 100,000 Americans died from drug overdoses.  
Challenges obtaining high-quality care for mental health and 
substance use compound the devasting effects of the Nations 
mental health and substance use disorder crises. 
HHS programs must improve behavioral health care and 
supports, such as by expanding community-based prevention 
efforts, enhancing access to affordable behavioral health 
treatments, and developing a diverse behavioral health 
workforce that can serve the public well and meet the needs of 
people from diverse backgrounds, understandings, and communication abilities. 
Improving Maternal Health  
Too many Americans die during pregnancy, childbirth, and the postpartum period.  More than 4 in 5 of these 
pregnancy-related deaths are preventable.  Black people, American Indian and Alaska Native people, and 
residents of rural areas suffer disproportionately high rates of maternal mortality and other pregnancy 
complications.  The Department must work to improve pregnancy-related care and eliminate racial, ethnic, 
geographic, and socioeconomic disparities in health outcomes for parents and newborns. 
 
 
3   
Strengthening Emergency Preparedness and  
Response Capabilities 
Public health emergencies (PHEs), such as communicable diseases and storms, fires, and human-caused 
disasters, severely strain public health and medical infrastructure.   
As PHEs increase in frequency and severity, HHS must build resilience and enhance preparation and response 
efforts to limit negative impacts on HHS programs and the public when these emergencies occur.  Additionally, 
HHS must strengthen the Nations emergency preparedness and response capabilities by enhancing public 
health infrastructure, including establishing highly functional data systems with accurate information about 
risk and response, a well-developed public health workforce, and mechanisms for effective coordination with 
States, localities, Tribes, and Federal intragovernmental partners.  HHS must foster public trust and improve 
communication to better lead response and recovery in future PHEs. 
Ensuring the Safety, Effectiveness, and Availability of Food 
and Drug Administration-Regulated Products 
HHSs Food and Drug Administration (FDA) regulates crucial consumer products, including human and 
veterinary drugs, biological products, medical devices, food, cosmetics, products that emit radiation, tobacco, 
and infant formula.  Fifteen cents of every dollar American consumers spend goes to these FDA-regulated 
products.  Reliance on overseas manufacturing, increasingly complex supply chains, novel threats from 
cyberattacks and other security vulnerabilities, and PHE-related disruptions complicate FDAs mission.  FDA 
must account for these threats and ensure the safety, effectiveness, quality, security, and availability of FDA-
regulated products.   
 
 OIG Highlighted Work 
  Opioid Overdoses and the Limited Treatment of    Toolkit: Insights for Communities From OIG's 
Opioid Use Disorder Continue To Be Concerns  Historical Work on Emergency Response 
for Medicare Beneficiaries 
  The Food and Drug Administration's Foreign 
  Instances of IHS Labor and Delivery Care Not  For-Cause Drug Inspection Program Can Be 
Following National Clinical Guidelines or Best  Improved To Protect the Nation's Drug Supply 
Practices 
 
 
 
 
4   
2 | Ensuring the Financial Integrity 
of HHS Programs 
Elements of the Challenge 
  Preventing, reducing, and recovering improper payments  
  Protecting programs from fraud, waste, and abuse  
  Controlling costs by ensuring prudent payments  
  Monitoring and reporting on the integrity of HHS financial management 
Given the $2.4 trillion investment in the HHS budget for fiscal 
year (FY) 2022 and the critical importance of the programs 
that HHS funds, the Department must work to ensure sound 
stewardship and combat fraud, waste, and abuse. 
Preventing, Reducing, and 
Recovering Improper Payments  
In FY 2022, improper payments for Medicare, Medicaid, and 
the Childrens Health Insurance Program (CHIP) were 
estimated at $131.6 billion.  Improper payments duplicate 
other payments, fund ineligible services, enrich ineligible providers, cover care for ineligible recipients, or 
violate other program rules. 
  Within the Medicare fee-for-service program, reducing improper payments remains a challenge 
despite the Centers for Medicare & Medicaid Services (CMSs) efforts targeting longstanding areas of 
concern, such as hospice, home health, hospital outpatient, and skilled nursing facility care.  Emerging 
areas of concern, such as aberrantly high-billing labs, upcoded hospital stays to increase 
reimbursement, and genetic testing, also require attention.  
  In the Medicaid program, HHS estimated that the FY 2022 improper payment rate exceeded 15 percent 
of all payments.  Exacerbating Medicaids challenges, the end of the COVID-19 PHE triggered Medicaid 
and CHIP eligibility changes that could impact millions of people.  States Medicaid enrollment and 
renewal processes must meet Federal statutory and regulatory requirements.  CMS has an oversight 
responsibility to ensure that these programs serve and maintain coverage for eligible beneficiaries.  
Correcting eligibility errors and recouping overpayments from State Medicaid agencies could be 
particularly challenging. 
 
 
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  HHS also disburses taxpayer dollars via grants and contracts.  The Department must provide guidance 
and up-to-date policies to inform grant recipients and subrecipients on financial management, internal 
controls, and Federal and Departmental Regulations.  This includes ensuring sufficient visibility into 
subrecipients use of grant funds to ensure grants are being used for their intended purpose.  For 
contracts, HHS needs to continue its efforts to improve the contract management and closeout 
processes. 
Protecting Programs From Fraud, Waste, and Abuse  
The Department must prevent, identify, and remedy fraud, waste, and abuse to ensure that taxpayer money 
serves important program goals and is not diverted for inappropriate, unauthorized, or illegal purposes.  The 
Department must enhance oversight and internal controls to guard against fraud schemes, including 
embezzlement and theft.  Novel fraud schemes, such as scams that use social media to offer fake grants, 
increase the need for vigilance.  
Suspension and debarment programs promote integrity for Federal grants and contracts by ensuring that the 
Federal Government does business only with responsible people.  HHS has improved its suspension and 
debarment programs by offering outreach, training, and guidance, but additional efforts are needed. 
Controlling Costs by Ensuring Prudent Payments  
HHS must assess its payment policies, including identifying problematic policies that create perverse 
incentives for providers or impede patients access to needed care.  To the extent feasible under current law, 
CMS should establish prudent payment policies that control costs and promote appropriate utilization.  
Prescription drugs are one area in which policymakers seek to reduce spending and increase coverage.  The 
Inflation Reduction Act requires the Department to implement certain complex new authorities, including 
negotiating prices for certain high-expenditure Medicare drugs.  The Department announced in August 2023 
the first 10 drugs subject to negotiation. 
Monitoring and Reporting on the Integrity of 
HHS Financial Management 
Within HHS, deficiencies persist in internal controls over segregation of duties, configuration management for 
approved changes to HHS financial systems, and access to HHS financial systems that could compromise 
financial management.  Although the Department has taken steps to improve its financial systems, it must 
take additional actions to address and resolve these issues, including continuing efforts to control user access, 
ensuring proper approval and documentation of supporting system changes, and ensuring appropriate 
segregation of duties. 
 
 
6   OIG Highlighted Work 
 CMS's Oversight of Medicare Payments for the  Medicare Telehealth Services During the First
Highest Paid Molecular Pathology Genetic Test Year of the Pandemic: Program Integrity Risks
Was Not Adequate To Reduce the Risk of up to
 Technical Assistance Brief: Implementation of
$888 Million in Improper Payments 
Inflation-Indexed Rebates for Part B Drugs
 HHS's Suspension and Debarment Program
 Medicare Could Have Saved up to $216 Million
Helped Safeguard Federal Funding, But
Over 5 Years if Program Safeguards Had 
Opportunities for Improvement Exist
Prevented At-Risk Payments for Definitive Drug 
 Nearly All States Made Capitation Payments for Testing Services 
Beneficiaries Who Were Concurrently Enrolled 
 Trend Toward More Expensive Inpatient
in a Medicaid Managed Care Program in Two 
Hospital Stays in Medicare Emerged Before
States 
COVID-19 and Warrants Further Scrutiny
 UPICs Hold Promise To Enhance Program
Integrity Across Medicare and Medicaid, But
Challenges Remain
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3 | Improving Outcomes 
in Medicare and Medicaid 
Elements of the Challenge 
  Combating fraud, waste, and abuse 
  Improving quality and safety in nursing homes 
  Strengthening oversight of managed care programs 
  Fostering equitable access to high-quality care 
 
More than 147 million American seniors, individuals with disabilities, people in low-income households, and 
individuals with end-stage renal disease and other complex health needs rely on Medicare and Medicaid, so 
HHS must ensure that these programs deliver high-quality care without disparate outcomes or barriers to 
access. 
Payment Incentive Risk Areas 
Combating Fraud, Waste, and Abuse 
Traditional Fee-for-Service: 
Minimizing fraud, waste, and abuse is critical to helping Medicare and    Inappropriate increased 
Medicaid programs deliver quality to enrollees and value to taxpayers.   utilization 
HHS must focus on fraud prevention (e.g., provider enrollment 
  Selection of more expensive 
screening and revalidation), detection (e.g., claims and other data 
services than needed 
analysis), and enforcement to recover misspent funds, protect patients 
  Improper patient steering 
from harm, and hold wrongdoers accountable.  The Department must 
remain vigilant to protect Medicare and Medicaid programs from fraud, 
Managed Care 
waste, and abuse across all service and provider types, but especially    Denying care 
those in high-risk areas, such as durable medical equipment, home 
  Discriminating against 
health, hospice, genetic testing, treatment for substance use disorder, 
patients who require costly 
COVID-19 test billing, and medical identity theft.  Different CMS 
care and services 
programs (e.g., managed care, traditional Medicare, value-based care 
  Manipulating/falsifying risk 
models) have different risks because they pay for services or coverage 
adjustment data 
differently.  As HHS revises payment policies and incentives, it must 
anticipate and guard against exploitation of specific payment designs. 
 
 
8   
Improving Quality and Safety in Nursing Homes
 
Nursing home residents deserve safe, high-quality care, yet improving nursing homes remains one of the most 
complex and intransigent challenges facing the American health care system.  The unprecedented COVID-19 
pandemic had widespread negative effects across the health care system.  It posed novel challenges for 
nursing home staff, residents, and families, and highlighted longstanding problems in areas such as emergency 
preparedness and infection control; staffing shortages; frontline oversight by CMS and State survey agencies; 
and health disparities based on race, ethnicity, and geography.  
HHS must continue to focus on improving nursing home performance, including ensuring sufficient staffing to 
meet residents needs, expanding transparency of private equity and other ownership information to better 
understand linkages to quality of care, and bolstering emergency preparedness and infection control.  The 
Department must continue to take meaningful steps to foster safe, high-quality, dignified care for residents in 
areas such as chemical restraints, facility-initiated discharges, and preventing abuse and neglect.  Finally, the 
Department must remain attentive to strengthening the effectiveness of State survey agency performance 
and the response to poor-performing nursing homes, such as through the Special Focus Facility Program.  
Improving nursing home care will require partnerships and sustained commitment from Government and 
 
private stakeholders to achieve positive change. 
Strengthening Oversight of Managed Care Programs 
As managed care continues to expand, now covering 
more than half of Medicare enrollees and more than  
80 percent of Medicaid enrollees, HHS must ensure 
that managed care operates effectively and 
efficiently.  The Medicare Advantage program suffers 
when Medicare Advantage organizations claim 
additional government payments by making their 
enrollees appear sicker than they might be or when 
plans avoid costs by denying care that would 
otherwise be covered by Medicare.  CMS must 
improve its oversight, including of chart reviews and 
health risk assessments conducted by plans, to ensure 
accurate risk-adjusted payments that truly reflect 
enrollees health status.  CMS must also improve its 
oversight of Medicare and Medicaid managed care to 
reduce inappropriate prior authorization and payment 
denials that serve plan profits over enrollees health.  Recently, CMS has taken steps to increase transparency 
and improve the information Medicare enrollees can access about Medicare Advantage organizations prior 
 
 
9   
authorization and coverage decisions, and it began phasing in updates to the Medicare Advantage risk 
 
adjustment model to improve the accuracy of Medicare Advantage. 
Fostering Equitable Access to High-Quality Care 
Disparities in access and quality of care and in health outcomes persist for Medicare and Medicaid enrollees in 
some geographic areas, members of some racial and ethnic groups, and individuals with intellectual and 
physical disabilities.  Disparities may be even more pronounced for access to high-quality prenatal care, 
mental health services, and treatment for substance use disorder.  During the COVID-19 PHE, Congress 
temporarily expanded access to telehealth for Medicare enrollees, resulting in a dramatic increase in use of 
telehealth.  However, telehealth use varied greatly among enrollees in different geographic areas and among 
certain demographic groups.  As the Department implements new telehealth policies, it must balance 
concerns about issues such as access, quality of care, health equity, privacy and security, and program 
integrity.  As HHS works to reduce health disparities, it must improve the accuracy of relevant data to help 
measure and facilitate progress in reducing disparities. 
 
 OIG Highlighted Work 
  Oversight of Managed Care for Medicare and    Some Medicare Advantage Organization 
Medicaid  Denials of Prior Authorization Requests Raise 
Concerns About Beneficiary Access to 
  Medicare Advantage Compliance Audit of 
Medically Necessary Care 
Diagnosis Codes That Humana, Inc., (Contract 
H1036) Submitted to CMS    CMS Should Take Further Action To Address 
States With Poor Performance in Conducting 
  High Rates of Prior Authorization Denials by 
Nursing Home Surveys 
Some Plans and Limited State Oversight Raise 
Concerns About Access to Care in Medicaid 
Managed Care 
 
 
 
   
 
 
111000     
4 | Protecting HHS Beneficiaries 
Elements of the Challenge 
  Ensuring safety and quality in Federal health care programs 
  Protecting the health and safety of children  
  Preventing abuse and neglect 
 
HHS programs provide and/or fund critical health care, child care, and educational services for diverse 
populations in hospitals, clinics, child care facilities, shelters, nursing homes, and peoples own homes.  
Ensuring that intended beneficiaries receive appropriate services that meet standards for quality, are free 
from abuse or neglect, and do not experience preventable harm represents a major challenge for the 
Department. 
Ensuring Safety and Quality 
in Federal Health Care Programs 
Federal health care programs must deliver care that meets quality and safety standards and that intended 
beneficiaries can access without undue burden or disparities.  Although HHS has made progress, more work 
remains to improve access to and quality of all types of care.  Too often, health care results in patient harm, 
much of which is preventable. 
 
 
11   
 
Protecting the Health and Safety of Children  
In addition to health care, HHS operates or funds programs that provide child care, education, and residential 
care to many children, such as children living in foster care and children in the Unaccompanied Children (UC) 
Program.  The Administration for Children and Families should work with States to increase compliance with 
Federal requirements to protect children in foster care from human trafficking.  Unaccompanied children who 
enter the United States without lawful immigration status are referred to the custody of the Office of Refugee 
Resettlement (ORR).  Most children are released from ORR care to a sponsor, usually a parent or other family 
member.  HHS strives to limit childrens time in ORR care while ensuring safe and appropriate release to 
vetted sponsors.  
For children who remain in ORR care, the Department must ensure that UC Program-funded facilities meet all 
health and safety requirements and provide adequate medical and mental health care.  HHS must continue to 
enhance efforts to ensure that all individuals with access to children have passed required background checks.     
Preventing Abuse and Neglect 
Thousands of HHS-funded providers hold positions of trust that bring them into close contact with individuals, 
often behind closed doors and at especially vulnerable times.  Most providers earn this trust and work hard to 
serve people well.  However, some providers harm people, and the Department must better protect those 
enrolled in its programs from abuse and neglect.  The Indian Health Service recently initiated extensive 
measures to protect patients from sexual predators after an Indian Health Service pediatrician went to prison 
for sexually assaulting boys he treated as patients.  These measures reflect meaningful progress, but better 
attention to protecting people of all ages at risk for abuse and neglect in all care settings is needed.  
Thoroughly vetting providers and staff by using background checks helps prevent potential predators from 
gaining access to victims in Federal programs.  The Department must ensure adequate background checks in 
HHS-funded child care programs and health care settings.   
Although awareness may be highest in pediatric settings and nursing homes, people in all care settings are at 
risk of abuse and neglect.  Identifying and reporting abuse and neglect is important but may be particularly 
challenging in non-facility settings, such as home and community-based services or group homes.  All States 
have enacted mandatory reporting laws that require professionals, such as teachers or nursing home staff, to 
report suspected abuse or neglect targeting certain individuals, but more must be done to help victims and 
hold wrongdoers accountable.  
States and other partners should use claims data to better identify unreported abuse and neglect, and CMS 
should compile a list of diagnosis codes that indicate potential abuse or neglect, conduct periodic data 
extracts, and encourage States to better use data to facilitate compliance with mandatory reporting laws.  
 
 
12   
CMS should ensure that its reporting requirements sufficiently protect individuals in all care settings and are 
adequately enforced.  Protecting people from abuse and neglect is a critical responsibility that requires 
attention and cooperation from all stakeholders. 
 
 OIG Highlighted Work 
  Adverse Events in Hospitals: A Quarter of    All Six States Reviewed Had Partially 
Medicare Patients Experienced Harm in  Implemented New Criminal Background Check 
October 2018  Requirements for Childcare Providers, and Five 
of the States Anticipate Full Implementation by 
  The Office of Refugee Resettlement Needs To 
Fiscal Year 2020 
Improve Its Oversight Related to the Placement 
and Transfer of Unaccompanied Children    In Five States, There Was No Evidence That 
Many Children in Foster Care Had a Screening 
  The Office of Refugee Resettlement Needs To 
for Sex Trafficking When They Returned After 
Improve Its Practices for Background Checks 
Going Missing 
During Influxes 
  A Resource Guide for Using Diagnosis Codes in 
  Toolkit: Insights from OIG's Work on the Office 
Health Insurance Claims To Help Identify 
of Refugee Resettlement's Efforts To Care for 
Unreported Abuse or Neglect 
Unaccompanied Children 
  Medicaid Data Can Be Used To Identify 
Instances of Potential Child Abuse or Neglect 
 
   
 
 
13   
5 | Securing Data and 
Technology  
Element of the Challenge 
  Improving cybersecurity for HHS programs, related industry sectors, and individuals 
HHS faces persistent cybersecurity threats that exacerbate 
HHS faces persistent 
the challenges associated with data and technologies used to 
carry out the Departments vital health and human service  cybersecurity threats that 
missions.  The large scale of HHSs mission and information 
exacerbate the challenges 
technology environments requires that the Department 
associated with data and 
simultaneously address a range of cybersecurity risks along 
with the specific data and technology needs for each  technologies used to carry out 
Operating Division/Staff Division (OpDiv/StaffDiv) or 
the Departments vital health 
program.   
and human service missions. 
Improving Cybersecurity for HHS 
Programs, Related Industry Sectors, and Individuals 
Cyberattacks and related threats can imperil critical HHS operations and programs, potentially compromising 
the health and welfare of individuals HHS serves.  Disparate organizational approaches to cybersecurity that 
vary by OpDiv/StaffDiv within the Department and across the Government complicate HHSs preparedness 
efforts to prevent or respond to cybersecurity risks.  Improving cybersecurity posture requires significant 
resource investments and cultural and organizational change across HHS.  The Department must ensure that 
its agencies and programs employ a risk-based approach to identifying and implementing information system 
security solutions to protect technology and data.     
Comprehensive cybersecurity solutions must be implemented not just within the Department but also by the 
thousands of HHS contractors, grantees, and other external entities.  For many HHS programs, effective 
cybersecurity will depend on these multiple parties implementing comprehensive security solutions that 
mitigate cyber threats specific to their operations.  Protecting technology and data also requires broader 
efforts beyond implementing technical cybersecurity fixes, such as establishing clear expectations; 
modernizing program rules; and conducting effective oversight of the Departments contractors, grantees, and 
other external entities.    
 
 
14   
HHS must also address significant cybersecurity threats for sectors it oversees.  For example, the health care 
industry remains a prime target for cyberattacks.  Bad actors continue to leverage the threat of interrupting 
patient care to extract ransoms or other value from health care entities.  The diffuse nature of HHS 
cybersecurity authorities and responsibilities complicates response efforts.  Some HHS OpDivs/StaffDivs have 
limited or no authority or expertise to address cybersecurity risks affecting sectors they oversee.  Besides HHS, 
other Federal departments, such as Federal law enforcement and the Department of Homeland Security 
Cybersecurity and Infrastructure Security Agency, share cybersecurity responsibilities, adding coordination and 
communication challenges.   
To address these challenges, the Department must lead a network of Federal agencies to improve the 
cybersecurity of the health care and public health sectors.  HHS has employed public-private partnerships to 
improve threat communication with industry partners, but challenges remain that the Department has limited 
tools to address, including the industrys reliance on legacy technology and workforce challenges.        
New approaches to delivering health care, such as expansion of telehealth and remote patient monitoring, can 
improve access to and quality of care while greater provider interconnectivity can enhance care coordination, 
but HHS must identify and address the cybersecurity risks associated with their use.  As cybersecurity threats 
and potential targets increase, HHS must maintain vigilance, expeditiously address vulnerabilities, and help the 
health care industry adapt. 
The Department must also work to protect the privacy of sensitive individual data replete throughout the 
health care system.  HHSs actions to enforce the decades-old Health Insurance Portability and Accountability 
Act (HIPAA) Privacy Rule and HIPAA Security Rule may not be sufficient to address contemporary privacy 
concerns or changes in how patient information is collected and used.  The Department must adapt as privacy 
and security needs evolve and provide guidance for patients and providers. 
 
 OIG Highlighted Work 
  The Centers for Medicare & Medicaid Services    Michigan MMIS and E&E Systems Security 
Should Improve Preventative and Detective  Controls Were Generally Effective, but Some 
Controls To More Effectively Mitigate the Risk  Improvements Are Needed 
of Compromise 
  Massachusetts MMIS and E&E System Security 
  The IHS Telehealth System Was Deployed  Controls Were Generally Effective, but Some 
Without Some Required Cybersecurity Controls  Improvements Are Needed 
  Maryland MMIS and E&E System Security 
Controls Were Partially Effective and 
Improvements Are Needed 
 
 
15   
Conclusion  
Careful attention to these top management challenges will help 
the Department achieve its crucial mission to manage taxpayer 
dollars responsibly, safeguard public health, and deliver high-
quality care and services.  
 
 
Stay In Touch 
 
 
HHS Office of Inspector General 
 
  OIGatHHS 
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Report Fraud, Waste, 
and Abuse 
OIG Hotline Operations accepts tips and complaints from all sources about 
potential fraud, waste, abuse, and mismanagement in HHS programs.  Hotline 
tips are incredibly valuable, and we appreciate your efforts to help us stamp 
out fraud, waste, and abuse. 
 
TIPS.HHS.GOV 
Phone: 1-800-447-8477  
TTY: 1-800-377-4950  
Who Can Report? 
Anyone who suspects fraud, waste, and abuse should report their concerns 
to the OIG Hotline.  OIG addresses complaints about misconduct and 
mismanagement in HHS programs, fraudulent claims submitted to Federal 
health care programs such as Medicare, abuse or neglect in nursing homes, 
and many more.  Learn more about complaints OIG investigates. 
How Does it Help? 
Every complaint helps OIG carry out its mission of overseeing HHS programs 
and protecting the individuals they serve.  By reporting your concerns to the 
OIG Hotline, you help us safeguard taxpayer dollars and ensure the success of 
our oversight efforts. 
Who is Protected? 
Anyone may request confidentiality.  The Privacy Act, the Inspector General 
Act, and other applicable laws protect complainants.  The Inspector General 
Act of 1978 states that the Inspector General shall not disclose the identity of 
an HHS employee who reports an allegation or provides information without 
the employees consent, unless the Inspector General determines that 
disclosure is unavoidable during the investigation.  By law, Federal employees 
may not take or threaten to take a personnel action because of 
whistleblowing or the exercise of a lawful appeal, complaint, or grievance 
right.  Non-HHS employees who report allegations may also specifically 
request confidentiality.