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Get the free OIG's Health Care Fraud Self-Disclosure Protocol - HHS.gov

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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICESForm Approved OMB No. 09381106CMS VOLUNTARY SELFREFERRAL DISCLOSURE PROTOCOL I. INTRODUCTION The physician selfreferral
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Gather all necessary documentation related to the health care services provided.
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Review all billing codes and ensure accuracy.
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Complete the OIG's Health Care Fraud reporting form with detailed information about the suspected fraud.
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Submit the form and supporting documentation to the OIG for review.

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OIG's health care fraud refers to fraudulent activities related to the Medicare and Medicaid programs, as investigated and prosecuted by the Office of Inspector General (OIG) within the Department of Health and Human Services. This includes schemes involving billing for services not rendered, overbilling, and providing unnecessary medical services.
Any health care provider or organization that participates in federal health care programs, including Medicare and Medicaid, is required to report any suspected health care fraud to the OIG.
To report health care fraud to the OIG, individuals or entities can fill out a complaint form available on the OIG's website or submit a report via phone. Detailed information regarding the fraudulent activity, including dates, locations, and involved parties, should be provided.
The purpose of OIG's health care fraud investigations is to protect the integrity of federal health care programs, safeguard taxpayer money, and ensure that patients receive necessary and appropriate medical care.
When filing a report on health care fraud, the following information is typically required: the name and contact information of the reporting individual, details of the suspected fraudulent activity, any relevant documentation or evidence, and the names of any individuals or organizations involved.
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