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Department of Health and Human Services OFFICE OF INSPECTOR GENERALHOSPITAL INCIDENT REPORTING SYSTEMS DO NOT CAPTURE MOST PATIENT HARM Daniel R. Levinson Inspector General January 2012 OEI060900091 E
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Proceed to provide details about your current or previous employment, including the name of the organization, your job title, and the dates of your employment. If you have multiple employers within the relevant time period, provide information for each one.
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Once you have completed all the required sections of the OIG HHS form, sign and date it in the designated area. Make sure to follow any additional submission instructions provided, such as mailing or electronically submitting the form.

Who needs OIG HHS:

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Healthcare professionals, including physicians, nurses, dentists, pharmacists, and other providers who participate in federal healthcare programs.
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Medical facilities, such as hospitals, clinics, nursing homes, and home health agencies that receive federal funding or reimbursements.
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Healthcare contractors, consultants, or vendors who work with federal healthcare programs or provide services to healthcare providers or facilities that participate in such programs.
Note: It is important to note that the need for the OIG HHS form may vary depending on specific circumstances or requirements set forth by different federal healthcare programs. It is advisable to consult the official guidelines or seek professional advice to determine if you are required to fill out the OIG HHS form.
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OIG HHS stands for Office of Inspector General Department of Health and Human Services.
Healthcare providers and entities receiving federal healthcare funding are required to file OIG HHS.
OIG HHS can be filled out online through the OIG website or submitted via mail.
The purpose of OIG HHS is to combat fraud, waste, and abuse in federal healthcare programs.
Information such as financial transactions, compliance programs, and conflicts of interest must be reported on OIG HHS.
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