US · guidance
CMS Pub. 100-08, ch. 4, § 4.3.2.2
OIG Hotline
The OIG Hotline is an OIG managed system that accepts tips and complaints from all
sources about potential fraud, waste, abuse in the Medicare, Medicaid and CHIP
programs. Complaints and any relevant documents originating from the OIG Hotline
will be sent to CMS by the OIG. CMS will conduct an initial screening of the complaints
received to determine which MAC should receive the complaint referral (Initial
screening of the complaint and assignment to the MAC will be based solely upon the
information provided to CMS by the OIG). CMS will then email the complaint to the
appropriate MAC via the OIG Hotline Referral mailbox established by the relevant
MAC. The email will contain the OIG Hotline Complaint Referral Template and any
supporting documentation, if available. The OIG Hotline Complaint Referral Template
will be populated with information relevant to the complaint. Due to the varying
information obtained from each complaint, some fields within the template may appear
blank because the information for the specific data field was not reported to the OIG
Hotline. Should the UPIC receive an OIG Hotline complaint directly from the OIG, the
UPIC shall proceed with the necessary screening, vetting, and investigative steps, as
described in sections 4.5, 4.6, and 4.7 of this chapter.
History
(Rev. 11032; Issued: 09-30-21; Effective: 10-12-21; Implementation: 11-10-21)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
cd4a58f157940bf50b282aaa99a8288a2fba950c3cd7fa1d0e030a437cefb661
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