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Our Inspector General Organization

Office of Investigations

The Office of Investigations is a Federal law enforcement agency. Its criminal investigators have statutory law enforcement authority with respect to U.S. Office of Personnel Management (OPM) programs and operations. In the Office of Investigations, we perform criminal, civil, and administrative investigations related to allegations of fraud, waste, or abuse affecting any OPM program, as well as gross mismanagement and employee misconduct by OPM employees and contractors.

We operate a fraud hotline for individuals to report allegations of fraud, waste, abuse, or mismanagement and misconduct directly to the Office of the Inspector General (OIG). Both the American taxpayers and Federal employees are harmed when OPM programs are defrauded or when misconduct compromises program integrity. We pursue criminal prosecution, civil action, and/or administrative penalties when appropriate. The Office of Investigations frequently partners with the Department of Justice (DOJ) and other Federal, State, and local law enforcement agencies to investigate cases nationwide.

The Office of Investigations receives complaints from various sources, including whistleblower complaints (sometimes identified as qui tam lawsuits) from the Department of Justice, contracted Federal Employees Health Benefits Programs (FEHBP) health insurance carriers’ antifraud units, other Federal agencies and law enforcement partners, and the general public. We use proactive data analysis to identify potential fraud trends in high-risk programs, perform program evaluations and reviews, and participate in health care fraud task forces across the country. When appropriate, we refer healthcare providers to the OPM Debarring Official for possible suspension or debarment from the FEHBP.

Our investigations include:

  • The Federal Employees Health Benefits Program is the largest employer-based healthcare program in the world, covering over 8.2 million current Federal employees, retirees, and their eligible family members. OPM, under Title 5 of the Code of Federal Regulations, is granted the authority to administer the FEHBP, which annually pays in excess of $50 billion for medical and pharmaceutical benefits, administrative fees, and other related costs. Every claim paid can be traced back to the United States Treasury that is ultimately used to reimburse medical providers, hospitals, pharmacies, and even members submitting claims. The Office of Investigations investigates cases related to false claims submitted by both FEHBP participants, healthcare providers, and pharmacies; instances of pharmaceutical fraud or drug diversion; and fraud committed by healthcare insurance carriers contracted to administer benefits on behalf of the FEHBP.
  • Civil Service Retirement System (CSRS) and the Federal Employees Retirement System (FERS): We investigate cases involving improper retirement payments made to deceased annuitants or their survivors; theft or diversion of annuity payments; and embezzlement from the Civil Service Retirement and Disability Fund. OPM pays approximately $80 billion annually in retirement related benefits.
  • National Background Investigations Bureau (NBIB): Although the Department of Defense will administer NBIB in the near future, the Office of Investigations continues to pursue cases related to the personnel security and suitability program operated by NBIB, which performs approximately 95% of the background investigations for the Federal Government. Our criminal investigations involve false statements in and the fabrication of background investigation reports by investigative personnel.
  • Combined Federal Campaign (CFC): The CFC is the largest and most successful annual workplace charity campaign. There are almost 200 CFC campaigns throughout the United States and overseas raising millions of dollars each year. In 2015, the CFC raised over $177 million in contributions from Federal employees. The Office of Investigations investigates fraud, theft, embezzlement, and gross mismanagement or misconduct related to the CFC program.
  • Other OPM Programs:The Office of Investigations also reviews and may conduct criminal, civil, and/or administrative investigations within the Federal Employees Group Life Insurance (FEGLI) program, Federal Employees Dental and Vision Program (FEDVIP), and the Federal Long Term Care Insurance Program (FLTCIP).
  • OPM employee and Contractor Misconduct: The Office of Investigations conducts criminal and administrative investigations of OPM employee and contractor misconduct, fraud, waste, and abuse.

Concerned citizens, OPM employees, OPM program offices, and OPM contractors may report suspected fraud, waste, and abuse to the OIG via the OIG Hotline by clicking on the following link: /our-inspector-general/hotline-to-report-fraud-waste-or-abuse/

ALERT! Don't be a victim of medical identity theft. Protect your insurance policy number as you would your credit card information and review your medical bills and explanation of benefits statements.
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