US · guidance
CMS Pub. 100-04, ch. 30, § 140.11
OIG Referral Procedures
The contractor will include in the sanction recommendation to the OIG/FO (to the extent
appropriate) the following:
• Identification of the Subject - The subject’s name, address and a brief description
of the subject’s special field of medicine.
• Origin of the Case - A brief description of how the violations were discovered.
• Statement of Facts - A statement of facts in chronological order describing each
failure to comply with the refund requirements in §1842(1).
• Documentation - Copies of written correspondence and written summaries of any
meetings or telephone contacts with the beneficiary and the physician regarding
the physician’s failure to make refund.
• Other Significant Issues - Any information that may be of value in the event of a
hearing to bar a physician from receiving Medicare payment.
History
(Rev. 1186, Issued: 02-23-07; Effective: 01-01-06; Implementation: 05-23-07)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
c006ca3c901d38125fe3008859b78120dfa8498f8b2ce2b023640a06eecd17ad
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