Medicare Program Integrity Manual (Pub. 100-08), Ch. 4 § 4.9.2.3
Continue to Monitor Provider and Document Case File
4.9.2.3 - Continue to Monitor Provider and Document Case File
(Rev. 11032; Issued: 09-30-21; Effective: 10-12-21; Implementation: 11-10-21)
Unless no additional administrative action and/or investigation is warranted, the UPIC
shall not close a case simply because it is not accepted by OIG/OI. Since the subject is
likely to continue to demonstrate a pattern of fraudulent activity, they shall continue to
monitor the situation and to document the file, noting all instances of suspected fraudulent
activity, complaints received, actions taken, etc. This will strengthen the case if it is
necessary to take further administrative action or there is a wish to resubmit the case to
OIG/OI at a later date. If the UPICs do resubmit the case to OIG/OI, they shall highlight
the additional information collected and the increased amount of money involved.