When the Government Calls…

When the Government Calls…

In the last few weeks, I’ve taken several sheepish calls from folks indicating that they received a call from a government agent and proceeded to participate in a long chat. They knew they shouldn’t do it, but guilt or fear, particularly the concern that declining to talk would anger the agent, overcame their judgment. So, this is the first of a few articles that will focus on dealing with contact from government agents.

I want to emphasize that when you get a phone call from someone who claims to be with the government, you shouldn’t believe them. While the odds are high that they are telling the truth, the risk that they are lying is still very real. I have seen at least five situations in which people have falsely claimed to be government agents.

Sometimes they are reporters or lawyers or wannabe whistleblowers attempting to gather information about an organization; other times they’re running a scam. Last year I talked about a situation in which two “agents” claimed to have found a doctor’s prescription pad in a car in Texas. They accused the doctor of conspiring with other members of his clinic to run an opioid ring. They cautioned him against talking with anyone else because that would be obstruction of justice. 

That “warning” was a misrepresentation of the law in a way that allowed the scammers to isolate their target. They told him his license was summarily suspended. They had spoofed a phone number from the FBI and sent a document purporting to be from a state medical board. It was an impressive forgery. The document looked authentic.

You need to make sure that everyone in your organization knows to question the authenticity of phone calls, and even of documents. Historically, phone calls from government agents were incredibly rare. In the past, I would have said “If it is a call, it is probably fake.” That is no longer true, and the change heightens the risk that telephonic schemes will become more common.

It isn’t always easy to verify the identity of a caller. I recently attempted to validate the authenticity of a U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) agent. While I know a number of agents throughout the country, I have never encountered this particular Virginia-based agent. I rapidly discovered that there is almost no easy way to confirm that the person is authentic without reaching out to another OIG agent and asking them to verify the person’s identity.

When the call is from a purported government agent, I hope you will have your legal counsel do the validation and return the call. But there may be times when you are trying to confirm someone’s identity. In that case, don’t use the phone number the person provided you.

Let’s call this the Vandelay Industries problem. Regular Seinfeld viewers will remember that George once asked Jerry to answer his phone “Vandelay Industries,” because George needed to provide a fake reference and gave out Jerry’s number as the contact for a former employer.

The Internet makes it easier for you to search for a phone for any organization. Whether they are claiming to be a reporter, a government official, or someone providing a job reference for a future employee, use the Internet to find a phone number for their organization, and then call that number and ask for the person, rather than using the number provided.

I have personal experience with this.

Many years ago, when hiring a nanny, I realized that our applicant was using a friend to pose as a former employer. 

In future articles, I will address other tips for interacting with government agents, but the message here is a simple one: don’t trust a phone call. When someone calls and says they’re from the government, get their name and phone number, and then turn it over to legal.

Let legal make sure the person is who they claim to be. But it wouldn’t hurt to remind legal that you don’t know the person is who they claim to be.    

Facebook
Twitter
LinkedIn

David M. Glaser, Esq.

David M. Glaser is a shareholder in Fredrikson & Byron's Health Law Group. David assists clinics, hospitals, and other health care entities negotiate the maze of healthcare regulations, providing advice about risk management, reimbursement, and business planning issues. He has considerable experience in healthcare regulation and litigation, including compliance, criminal and civil fraud investigations, and reimbursement disputes. David's goal is to explain the government's enforcement position, and to analyze whether this position is supported by the law or represents government overreaching. David is a member of the RACmonitor editorial board and is a popular guest on Monitor Mondays.

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Mastering Principal Diagnosis: Coding Precision, Medical Necessity, and Quality Impact

Mastering Principal Diagnosis: Coding Precision, Medical Necessity, and Quality Impact

Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.

December 3, 2025

Proactive Denial Management: Data-Driven Strategies to Prevent Revenue Loss

Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.

November 25, 2025
Sepsis: Bridging the Clinical Documentation and Coding Gap to Reduce Denials

Sepsis: Bridging the Clinical Documentation and Coding Gap to Reduce Denials

Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.

September 24, 2025

Trending News

Featured Webcasts

AI in Claims Auditing: Turning Compliance Risks into Defensible Systems

As AI reshapes healthcare compliance, the risk of biased outputs and opaque decision-making grows. This webcast, led by Frank Cohen, delivers a practical Four-Pillar Governance Framework—Transparency, Accountability, Fairness, and Explainability—to help you govern AI-driven claim auditing with confidence. Learn how to identify and mitigate bias, implement robust human oversight, and document defensible AI review processes that regulators and auditors will accept. Discover concrete remedies, from rotation protocols to uncertainty scoring, and actionable steps to evaluate vendors before contracts are signed. In a regulatory landscape that moves faster than ever, gain the tools to stay compliant, defend your processes, and reduce liability while maintaining operational effectiveness.

January 13, 2026
Surviving Federal Audits for Inpatient Rehab Facility Services

Surviving Federal Audits for Inpatient Rehab Facility Services

Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.

November 13, 2025
E/M Services Under Intensive Federal Scrutiny: Navigating Split/Shared, Incident-to & Critical Care Compliance in 2025-2026

E/M Services Under Intensive Federal Scrutiny: Navigating Split/Shared, Incident-to & Critical Care Compliance in 2025-2026

During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.

August 26, 2025

Trending News

Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24