US · guidance
CMS Pub. 100-08, ch. 4, § 4.14
Fraud Alerts & HPMS Memos
This section applies to UPICs.
Fraud Alerts are issued when circumstances arise that indicate a need to advise the
UPICs, SMRCs, MACs, LE, state Medicaid agencies, and other appropriate stakeholders
about an activity that resulted in the filing of inappropriate and potentially false
Medicare claims. If the UPIC identifies the need for a Fraud Alert, it shall provide the
BFL, with a copy to the COR, a summary of the circumstances. The CMS will evaluate
the need to issue a Fraud Alert. All Fraud Alerts will be disseminated by CMS to the
appropriate stakeholders.
The following direction applies to the I-MEDIC:
HPMS Memos are issued when circumstances arise that indicate a need to advise the
Part C plans and Part D Plan Sponsors, and other appropriate stakeholders about an
activity that resulted in the filing of inappropriate and potentially false Medicare claims.
If the I-MEDIC identifies the need for an HPMS Memo, it shall provide the BFL, with a
copy to the COR, a summary of the circumstances. CMS will evaluate the need to issue
an HPMS Memo. All HPMS Memos will be disseminated by CMS to the appropriate
stakeholders through the HPMS Portal.
History
(Rev. 12127; Issued: 07-21-23; Effective: 08-21-23; Implementation: 08-21-23)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
aef9fe5e891f7b29e52e76e654263612cdd75ae69f6365987932ff9e289e2829
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