Medicare Program Integrity Manual (Pub. 100-08), Ch. 4 § 4.2.2.8.1
Unified Program Integrity Contractor Coordination with
4.2.2.8.1 - Unified Program Integrity Contractor Coordination with
Unified Program Integrity Contractors and Other Entities
(Rev. 11032; Issued: 09-30-21; Effective: 10-12-21; Implementation: 11-10-21)
This section applies to UPICs.
The UPIC shall coordinate with UPICs in other jurisdictions, as directed in the USOW
and Task Order Statement of Works (SOWs).
The UPIC shall establish and maintain formal and informal communication with state
survey agencies, the OIG, the DOJ, state Medicaid agency, other Medicare contractors,
other UPICs, and other organizations as applicable to determine information that is
available and that should be exchanged to enhance program integrity activities.
If the UPIC identifies a potential quality problem with a provider or practitioner in its
area, it shall refer such cases to the appropriate entity, be it the QIO, state medical board,
state licensing agency, etc. Any provider-specific information shall be handled as
confidential information.