decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Program_Memos / 2000 / AB-00-23
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Article Overview
This Program Memorandum from HCFA addresses how Medicare contractors should respond to fraud complaints referred by Medigap insurers. It is relevant to Medicare program integrity staff, carriers, intermediaries, and compliance professionals who track federal guidance on referrals, review actions, and administrative follow-up. The memorandum also includes implementation timing and administrative contact information.
Why This Topic Matters
It helps readers understand the federal handling of fraud referrals originating from Medicare supplemental insurers and the associated contractor responsibilities for follow-up actions and protecting program funds.
Article Sections
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Subject and Purpose
Introduces the memorandum topic and the general program integrity issue being addressed.
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Required Contractor Response
Summarizes the types of follow-up actions contractors are directed to consider after receiving certain referrals.
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Effective Date and Administrative Information
Provides the timing for implementation and the memorandum’s administrative contact and retention details.
What You Will Learn
- What the memorandum addresses at a high level
- Which contractor audiences are affected
- What categories of follow-up activity are discussed
- What timing and administrative details accompany the guidance
Who Should Read This
- Medicare contractors
- Carriers
- Intermediaries
- Program integrity staff
- Compliance and fraud investigation professionals
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