Certified Application Counselor Practice Test

What agency should be contacted for suspected fraud in health care enrollment?

1. Social Security Administration

2. Federal Bureau of Investigation

3. HHS Office of the Inspector General

4. Department of Health and Human Services

The correct answer is: HHS Office of the Inspector General

The correct choice, the HHS Office of the Inspector General (OIG), is the appropriate agency to contact for suspected fraud in health care enrollment because this office is specifically tasked with combating fraud, waste, and abuse in the Department of Health and Human Services programs. They oversee investigations and audits regarding the integrity of health care funding and enrollee eligibility, making them uniquely positioned to handle such reports. When individuals suspect fraud related to health care enrollment, reporting to the OIG ensures that the issue will be directed to the right authorities who are equipped to handle such cases effectively. Their role includes protecting the integrity of vital health programs such as Medicare and Medicaid, which are often impacted by fraudulent activities. Other agencies, such as the Social Security Administration, the Federal Bureau of Investigation, and the Department of Health and Human Services, play important roles in their areas, but they do not specifically focus on investigating health care enrollment fraud in the same manner as the HHS Office of the Inspector General. Therefore, for concerns specifically about enrollment fraud, the OIG is the proper point of contact.