US · guidance
CMS Pub. 100-08, ch. 4, § 4.9.2.3
Continue to Monitor Provider and Document Case File
Unless no additional administrative action and/or investigation is warranted, the UPIC
shall not close a case simply because it is not accepted by OIG/OI. Since the subject is
likely to continue to demonstrate a pattern of fraudulent activity, they shall c ontinue to
monitor the situation and to document the file, noting all instances of suspected fraudulent
activity, complaints received, actions taken, etc. This will strengthen the case if it is
necessary to take further administrative action or there is a wish to resubmit the case to
OIG/OI at a later date. If the UPICs do resubmit the case to OIG/OI, they shall highlight
the additional information collected and the increased amount of money involved.
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
ff269e53980ec1b0a737f96e317f3ba4b1d38232279787833477802274aaf57a
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.