decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Program_Memos / 2000 / AB-00-56
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Article Overview
This program memorandum explains a Medicare contractor communication update concerning how fraud referrals are shared between HHS/HCFA, the Office of Inspector General, and the FBI. It is intended for Medicare intermediaries and carriers, and covers referral handling, notification timelines, and related follow-up procedures tied to existing manual instructions.
Why This Topic Matters
It helps Medicare contractors understand the current fraud-referral workflow and the agencies involved so they can route and follow up on cases appropriately.
Article Sections
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Subject and purpose
Introduces the memorandum and the general topic of fraud referral sharing between federal oversight and law enforcement entities.
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Current referral process and agency roles
Summarizes the contractor referral pathway and the roles of the oversight office and law enforcement agencies in handling received matters.
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New procedures for law enforcement
Describes the revised information-sharing process, expected notification timing, and follow-up contacts for unresolved referrals.
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Effective date and implementation
Lists the memorandum’s effective and implementation timing, along with budget and retention notes.
What You Will Learn
- How the memorandum changes communication among federal agencies involved in Medicare fraud referrals.
- Which organizations are involved in the referral-sharing process.
- What timing and follow-up expectations are described for contractor referral handling.
- Which existing manual instructions remain relevant to contractor actions.
Who Should Read This
- Medicare contractors
- Intermediaries
- Carriers
- Compliance and fraud prevention staff
- Healthcare reimbursement administrators
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