Coordination with the Office of Inspector General

4.2.2.8.1.1 - Coordination with the Office of Inspector General (Rev. 11962; Issued: 04-21-23; Effective: 05-22-23; Implementation: 05-22-23) The UPICs shall establish regular (i.e., monthly or quarterly) teleconference meetings with Regional LE from OIG and CMS for the purpose of discussing: • the status of referrals and immediate advisements; • any relevant updates to previously discussed cases (i.e., contractor identified spikes in billing, change to the operational status of a provider, patient harm situations, etc.); • data analysis projects (i.e., planned data projects, results of recently completed data projects, etc.); and • areas of interest to CMS, OIG, or other regional partners. Other agenda topics may include a discussion regarding areas of concern in the UPIC and/or Regional LE respective region, case/project developments (including planned provider onsite reviews to ensure the proposed activities do not negatively affect any ongoing LE efforts), and other topics. In preparation for the meeting, the UPIC shall set the agenda and prepare any additional documents or reports for the participants at least three (3) business days prior to the meeting. However, at no time shall a referral be made as a result of discussions during these regular meetings. If OIG expresses interest, the contractor shall discuss the case with the BFL, with a copy to the COR, to determine if it should be added to the next case coordination meeting with CMS.