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US · guidance

CMS Pub. 100-09, ch. 6, § 30.11

Fraud and Abuse

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

MACs shall immediately send any provider inquiry or complaint about fraud and abuse to the Unified

Program Integrity Contractor (UPIC), along with a referral package (see Pub. 100-08, Chapter 4,

section 4.3.2.4). The UPIC may request additional information to resolve the complaint/referral or

during the subsequent development of a related case (for example, provider/supplier enrollment

information).

The MAC shall maintain a copy of all referral packages.

History

(Rev. 13683; Issued: 04-08-26; Effective: 05-08-26; Implementation: 05-08-26)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
3f94f95a8428bc3647b542980fa96e152b3e57287703bf200a247bef9c7d56d1
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