Escalated Inquiries Involving Investigative Outcomes and

4.8.4.2 – Escalated Inquiries Involving Investigative Outcomes and Administrative Actions (non-payment suspension escalations) (Rev. 13821; Issued:06-09-26; Effective: 02-26-26; Implementation: 02-26-26) If a matter is escalated, such as when a provider, supplier, and/or their authorized representative requests to speak with UPIC or I-MEDIC management through verbal or written communication, the contractor shall contact the inquiring party in a manner which they deem most appropriate to acknowledge the inquiry or concern and provide a response within 3 business days unless circumstances prevent this, and/or CMS has already advised on the same topic. This ensures transparency and responsiveness once a matter reaches a heightened level of concern. The contractor representative shall ensure all mailboxes and phone messages are checked at least twice each business day for incoming communication. Escalated inquiries referred to CMS directly by the provider, supplier, or their authorized representative will be responded to by the designated Business Function Lead(s) (BFLs) in the Division of Provider Investigations (DPI) after clearance through the Fraud Investigations Group Front Office (FIG FO) in accordance with current guidelines.