CMS Pub. 100-06, ch. 5, § 410.3

All Medicare systems shall be able to separately distinguish and track

unsolicited/voluntary refund checks which result from a 1) provider/physician/supplier

and other entity under a CIA; 2) Provider/physician/supplier and other entity under the

OIG Self-Disclosure Protocol; and 3) Straight Refund (a straight refund is a refund from

a provider/physician/supplier, or other entity who is not under a CIA nor the OIG Self-Disclosure Protocol). All Medicare systems shall have the ability to identify and produce

a report that distinguishes a refund as a CIA, OIG Self-Disclosure Protocol, or straight

refund at the point of disposition (i.e., after investigation of the origin of the refund).

To assist in identifying providers/physicians/suppliers under a CIA, Medicare contractors

should access the OIG Web site (http://www.oig.hhs.gov/fraud/cias.html) for a list of all

providers/physicians/suppliers, and other entities under a CIA. The OIG Web site will

also give the effective date of the CIA. To obtain the termination date of the CIA, click

on the CIA agreement. The time period of the CIA is contained within the agreement. If

the Web site does not provide enough information to determine whether a CIA agreement

is in existence, the contractor shall contact the provider as part of their

investigation/resolution of the unsolicited/voluntary refund. Because OIG Self-Disclosure Protocol agreements are voluntary, contractors may not be aware of this

agreement unless a provider/physician/suppliers or other entity specifically notifies them.

Providers/physicians/suppliers under an OIG Self-Disclosure Protocol agreement are not

given on the OIG Web site. The OIG will send a letter directing the

provider/physician/supplier to refund money back to the Medicare contractor when the

OIG has completed the Self-Disclosure matter and determined that an

unsolicited/voluntary refund should be collected rather than a civil settlement pursued. A

copy of the letter is included as Exhibit 3. The OIG will also send a copy of the letter to

the attention of the Chief Financial Officer for Medicare Operations at the Medicare

contractor. The OIG will direct the provider/physician/supplier to identify that the refund

check is the result of an OIG Self-Disclosure Protocol agreement. The

provider/physician/supplier will have 30 days to refund the contractor. If the contractor

does not receive the refund within 30 days, the contractor shall notify the Office of

Counsel to the Inspector General (OCIG) attorney assigned to the OIG Self-Disclosure

Protocol matter, as identified in the letter.