How to Ensure Your Hotline is Effective

The growth of hotlines over the last decade has been nothing short of phenomenal. Beginning as a Defense Industry initiative, hotlines have been used successfully for decades to communicate potential fraud problems. They have also been included in a wide variety of compliance guidance standards, regulations and laws across the healthcare compliance industry.

The U.S. Sentencing Commission Guidelines for Organizations has called for hotlines as far back as 1991. Since 1998, the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) has been promoting hotlines in their compliance program guidance as a critical element of any Compliance Program. The passage of the Sarbanes-Oxley Act in 2002 mandated that covered entities have a hotline, and the Privacy and Security Rules under the HIPAA promote the importance of using hotlines. Even the Supreme Court has declared that hotlines are needed to raise an affirmative defense for unlawful harassment.

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While these agencies stress the benefits of hotlines and have been promoting them for years, the problem for many is trying to determine how and what an effective hotline function should look like. The following are some key elements that make a hotline operation effective:

  1. Establishing the Hotline. Employee hotlines are one of the most tangible components of your Compliance Program because they are reporting channels that workforce members can use without fear of retaliation. Fortunately, a hotline is easy to establish and establishment of an internal hotline can be set-up with relative ease. However, many firms specialize in hotline operation for a fee, providing a toll- free line, 24-hours, 7 days per week, 365 days per year. They may also provide live operators, online reporting, foreign language interpreter service and other elective services depending on the needs of the organization. Yet, simply turning on a telephone does not mean that you have an effective hotline.
  2. Establish an Objective for the Hotline Function. To ensure effectiveness of the hotline operation, you must start with a clear objective for the hotline. The U.S. Sentencing Commission Guidelines Manual suggests that organizations establish a reporting system whereby employees can report misconduct without fear of retribution. This is the primary objective of the hotline. To support this objective, organizations should establish supporting policy and procedure documents, including those that state guaranteed employee anonymity and confidentiality when using the hotline.
  3. Establish a Basic Plan of Operation. A hotline operation extends beyond the telephone number or online reporting module; it includes an objective, operating protocol and procedures, security measures, investigation, follow-up and resolution. The operating protocol and procedures are the details of how the hotline will function, including the hours of operation, report preparation, response times, etc. This information may be included in the hotline program policies, but it would be more appropriate to include in a designated operations manual.
  4. Develop and Implement Hotline Related Policies. A number of policy documents are needed to ensure the hotline will be able to function as effectively as possible. These documents should include information on the manner by which the calls are answered, online reports are received, and cases are documented and acted upon by those responsible for its operation. Additionally, other necessary policies are needed to establish an efficient hotline operation across the entire workforce, including: (a) duty to report, (b) anonymity/confidentiality, (c) non-retaliation/retribution, (d) Work protocols between the Compliance Department, Legal Counsel and Human Resources, (e) investigation and case management of allegations and complaints, (f) reporting to external authorities, (g) auditing and monitoring hotline operations. By implementing these policies in advance of a serious allegation, you can avoid organizational risk and help ensure an effective outcome of the situation.
  5. Conduct Periodic Reviews of Operations. An important way to assess hotline effectiveness is a periodic review of call volume and quality of calls made to the hotline. When call topics are generally appropriate for the hotline (i.e., compliance concerns), it is a positive indicator that the workforce is willing to use the hotline and have a good understanding of its purpose.
  6. Assess Follow-up on Hotline Reports. An assessment of the steps following receipt of a report is often overlooked in hotline operations. If the primary function of a hotline is to receive allegations of misconduct or compliance concerns, then the Chief Compliance Officer (CCO) should carefully review the process to follow-up on reports. Furthermore, our experience is that HHS OIG looks very closely at the activities following receipt of a …


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