Medicare Program Integrity Manual (Pub. 100-08), Ch. 4 § 4.8.4.4
Providers on Zone Restrictions
4.8.4.4 – Providers on Zone Restrictions
(Rev. 13821; Issued:06-09-26; Effective: 02-26-26; Implementation: 02-26-26)
To maintain the integrity of the investigation, UPICs generally, unless otherwise advised,
do not respond to provider and supplier inquiries when the provider or supplier is placed
on full zone restriction by law enforcement (LE). However, UPICs are encouraged to
communicate with the LE contact in such situations to determine the best and appropriate
course of action. For partial zone restrictions, UPICs may conduct certain investigative
activities in accordance with directives by LE; however, communication and responses to
inquiries regarding the case or status by the provider or supplier should not be conducted
unless otherwise directed by LE.
All communication between the UPICs/I-MEDIC and a provider, supplier, or their
authorized representative, including receipt of inquiry, coordination with CMS, and
response to the inquirer, shall be documented in the appropriate UCM CSE(s).