Medicare Contractor Role in Fraud Enforcement / Requests for Information From Outside Organizations / Requests From Contractors, PROs and Others

Article Overview

This article is a brief Medicare program integrity note about how contractors may share specific information in the context of ongoing fraud investigations. It is relevant to compliance staff, billing and coding professionals, audit teams, and organizations that interact with Medicare contractors, survey agencies, Medicaid Fraud Control Units, and state attorneys general. The discussion centers on the general scope of information requests and the types of outside entities involved.