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US · guidance

CMS Pub. 100-06, ch. 6, § 70.8

Type of Fraud Workload Item (Inactive)

activein force · 2026-08-25 – presentas-observed

A3-3898.8

The intermediary reports fraud workload items in the following columns for all lines of

Form M:

Column (1) – Total – All fraud workload items.

Column (2) – Beneficiary Complaints – The intermediary reports the number of

complaints received from, or on behalf of, beneficiaries alleging fraud. Do not include

complaints filed with the Office of the Inspector General (OIG) Hotline.

Column (3) – OIG Hotline – The intermediary reports the number of complaints

received via the OIG Hotline.

Column (4) – Referrals and Other – The intermediary reports referrals and any other

workload received by the fraud unit (e.g., provider complaints, internally generated

referrals from medical review, special requests from OIG or CMS).

History

(Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
b48572f08b438c706d5d07eeb6788ab08c8a76fb1a460000b82df0fc05393ef8
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