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Reporting Fraud | CMS
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href="/medicare/payment/medicare-advantage-rates-statistics" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169841">Medicare Advantage Rates & Statistics</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded menu-item--active-trail"> <span class="menu-item-element" aria-current="false">Medicare-Medicaid coordination</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/medicaid-coordination/about" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/174821">Medicare-Medicaid Coordination Office</a> </li> <li class="menu-item 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menu-item--collapsed"> <a href="/medicaid-chip/medicare-coordination/financial-alignment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/178246">Financial alignment initiative</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicaid-chip/medicare-coordination/avoidable-hospitalizations" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/181236">Initiative to reduce avoidable hospitalizations </a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/medicaid-coordination/center-program-integrity/reports-guidance" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/674951">Reports & Guidance</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/medicaid-coordination/pace" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175651">Program of All-Inclusive Care for the Elderly (PACE)</a> </li> <li class="menu-item menu-item--l3 menu-item--active-trail"> <a href="/medicare/medicaid-coordination/center-program-integrity/reporting-fraud" class="menu-item-element active-page is-active" aria-current="page" data-drupal-link-system-path="node/674956">Reporting Fraud</a> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/medicaid-coordination/plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/178296">Resources for Medicare-Medicaid plans</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/medicaid-coordination/states" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1355341">Resources for state Medicaid agencies</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1313131">Healthcare Fraud Prevention Partnership</a> </li> <li class="menu-item menu-item--l3"> <a href="/about-cms/information-systems/clinical-templates" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/189991">Clinical Templates</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Appeals & grievances</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/appeals-grievances/fee-for-service" class="menu-item-element" aria-current="false" 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data-drupal-link-system-path="qic-decision-search">Appeals Decision Search (Part C & Part D)</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Quality</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/value-based-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/188566">Value-based programs</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/quality/initiatives/hospital-quality-initiative/person-family-engagement" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/182996">Person & Family Engagement</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/quality-improvement-organizations" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169871">Quality improvement organizations</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/nursing-home-improvement" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171236">Nursing home quality improvement</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/inpatient-rehabilitation-facility" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175616">Inpatient Rehabilitation Facility (IRF) Quality Reporting Program (QRP)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/home-health" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170541">Home Health Quality Reporting Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/end-stage-renal-disease-esrd-quality-incentive-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176126">ESRD Quality Incentive Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/meaningful-measures-initiative/cms-quality-strategy" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/178276">CMS National Quality Strategy</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/hospice" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175556">Hospice Quality Reporting Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/long-term-care-hospital" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175511">Long-Term Care Hospital (LTCH) Quality Reporting Program (QRP)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/appropriate-use-criteria-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/180421">Appropriate Use Criteria Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/measures" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172001">Quality measures</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/clinical-laboratory-improvement-amendments" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172651">Clinical Laboratory Improvement Amendments (CLIA)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/advantage-quality-improvement-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/177561">Medicare Advantage quality improvement program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/physician-compare-initiative" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175221">Physician compare initiative</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/initiatives" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169636">Quality initiatives</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/part-c-d-performance-data" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171491">Part C and D Performance Data</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/snf-quality-reporting-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/180061"> Skilled Nursing Facility (SNF) Quality Reporting Program (QRP)</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Health & safety standards</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/quality-safety-oversight-general-information" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169631">Quality, safety & oversight - General information</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-safety-standards/accreditation-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171481">Accreditation programs</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-safety-standards/civil-monetary-penalties" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/182431">Civil monetary penalties</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/quality-safety-oversight-emergency-preparedness" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172346">Quality, safety & oversight - Emergency preparedness</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-safety-standards/state-survey-agencies" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171271">State survey agencies</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/certification-compliance" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171241">Certification & compliance</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/enforcement" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169811">Enforcement</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/guidance-for-laws-regulations" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170071">Quality, safety & oversight - Guidance for laws & regulations</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/promising-practices-project" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172211">Promising practices project</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-safety-standards/education-division" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/173371">Quality, safety & oversight - Education division (QSED)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/conditions-coverage-participation" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172616">Conditions for coverage & participation</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Employers & plan sponsors</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/employers-plan-sponsors/creditable-coverage" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171701">Creditable coverage</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2"> <span class="menu-item-element" aria-current="false">IC-Placeholder-1</span> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Audits & Compliance</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/audits-compliance/part-a-cost-report" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/185256">Part A cost report audit</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/audits-compliance/part-c-d" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175921">Part C/Part D compliance & audits</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Forms & notices</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/medicare/forms-notices/cms-forms" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170166">CMS forms</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/forms-notices/cms-forms-list" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/174306">CMS forms list</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/forms-notices/beneficiary-notices-initiative" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170686">Beneficiary Notices Initiative (BNI)</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Health & drug plans</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-drug-plans/plan-payment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171981">Plan payment</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/plan-payment-data" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175081">Plan payment data</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/medical-loss-ratio" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/180161">Medical loss ratio</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/coverage-gap-discount-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175906">Coverage Gap Discount Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-drug-plans/managed-care-marketing" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170611">Managed care marketing</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/medicare-advantage-application" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170651">Medicare Advantage application</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-drug-plans/medigap" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170466">Medigap (Medicare supplement health insurance)</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/medical-savings-account" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172066">Medical Savings Account (MSA)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-drug-plans/private-fee-for-service-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170301">Private Fee-for-Service Plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/enrollment-renewal/health-plans/prepayment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170521">Health Care Prepayment Plans (HCPPs)</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/enrollment-renewal/health-plans/cost" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170656">Cost plans</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/enrollment-renewal/special-needs-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171676">Special needs plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/network-adequacy" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171301">Network adequacy</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Coordination of benefits & recovery</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/overview" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/177001">Overview</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/mandatory-insurer-reporting-group-health-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176856">Mandatory Insurer Reporting for Group Health Plans (GHP)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/mandatory-insurer-reporting" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176951">Mandatory insurer reporting (NGHP)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/workers-comp-set-aside-arrangements" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176641">Workers' comp Medicare set aside arrangements</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/attorney-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/177026">Attorney services</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/beneficiary-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/177036">Beneficiary services</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/coba-trading-partners" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176761">COBA Trading Partners</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/employer-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170361">Employer services</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/insurer-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170846">Insurer services</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/prescription-drug-assistance-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176791">Prescription drug assistance programs</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/provider-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170406">Provider services</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Settlements</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/medicare/settlements/jimmo" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193381">Jimmo Settlement</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/settlements/ryan" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193486">Ryan Settlement</a> </li> </ul> </div> </div> </li> </ul> </div> </li> <li class="menu-item menu-item--l1 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Medicaid/CHIP</span> <div class="subnav-wrapper--1 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-main ds-u-lg-display--none">Back to main menu</span> <h2 class="subnav-title-h2" style="position:relative;text-align:left;width:auto;height:auto;">section title h2</h2> </div> <ul class="menu"> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">What is Medicaid?</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="https://www.medicaid.gov" class="menu-item-element" aria-current="false">Visit Medicaid.gov</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.medicaid.gov/about-us/beneficiary-resources/index.html#statemenu" class="menu-item-element" aria-current="false">View Medicaid maps</a> </li> <li class="menu-item menu-item--l3"> <a href="http://www.medicaid.gov/chip/index.html" class="menu-item-element" aria-current="false">Visit CHIP.gov</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Medicare-Medicaid Coordination</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/medicaid-chip/medicare-coordination/integrated-care-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/174926">Integrated care resources</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicaid-chip/medicare-coordination/avoidable-hospitalizations" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/181236">Initiative to reduce avoidable hospitalizations</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicaid-chip/medicare-coordination/financial-alignment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/178246">Financial alignment initiative</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicaid-chip/medicare-coordination/integrity-institute" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1315141">Medicaid Integrity Institute</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2"> <span class="menu-item-element" aria-current="false">RG-Placeholder-1</span> </li> <li class="menu-item menu-item--l2"> <span class="menu-item-element" aria-current="false">IC-Placeholder-2</span> </li> </ul> </div> </li> <li class="menu-item menu-item--l1 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Marketplace & Private Insurance</span> <div class="subnav-wrapper--1 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-main ds-u-lg-display--none">Back to main menu</span> <h2 class="subnav-title-h2" style="position:relative;text-align:left;width:auto;height:auto;">section title h2</h2> </div> <ul class="menu"> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">About the Marketplace</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/about/oversight" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191061">Marketplace oversight</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/about/affordable-care-act" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191416">Affordable Care Act</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/about/overview-exchanges" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190921">Overview of the exchanges</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/about/exchange-coverage-maps" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193086">Exchange coverage maps</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/about/medicare" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/179351">Medicare and the Marketplace</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Private Health Insurance</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/patient-bill-of-rights" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192591">Patient’s Bill of Rights</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/medical-loss-ratio" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190956">Medical loss ratio</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/annual-limits" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191976">Annual limits</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/review-insurance-rates" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192716">Review of insurance rates</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/market-rating-reforms" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191816">Market rating</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/self-funded-non-federal-governmental-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191111">Self-funded, non-federal governmental plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/grandfathered-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191456">Grandfathered plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/health-reimbursement-arrangements" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193216">Health Reimbursement Arrangements</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/coverage-young-adults" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190931">Coverage for young adults</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/student-health-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190946">Student health plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/mental-health-parity-addiction-equity" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192601">Mental health parity and addiction equity</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/prevention" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191071">Prevention</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/consumer-protections-enforcement" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192701">Consumer protections & enforcement</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/pre-existing-condition-plan" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191056">Pre-existing condition insurance plan</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/glossary/qualifying-health-coverage" class="menu-item-element" aria-current="false">Qualifying Health Coverage (QHC)</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2"> <span class="menu-item-element" aria-current="false">RG-Placeholder-2</span> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">In-person assisters</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/in-person-assisters/information-partners" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2078851">Information for Partners</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/outreach-education" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073436">Assister outreach & education</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/applications-forms-notices" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073441">Applications, forms, & notices</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/programs-procedures" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073446">Assister programs & procedures</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/technical-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073231">Assister technical resources</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/training-webinars" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073451">Assister training & webinars</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Agents & Brokers</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192876">Resources for Agent & Brokers</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/registration-training" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1290426">Registration & training</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/open-enrollment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193226">Open enrollment</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/direct-enrollment-partners" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1550226">Direct enrollment partners</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/general-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/185021">General resources</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.youtube.com/playlist?list=PLaV7m2-zFKpgUK9AqdbnOdW69-WwodvRj" class="menu-item-element" aria-current="false">Video Learning Center</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.agentbrokerfaq.cms.gov/s/" class="menu-item-element" aria-current="false">Agent & Broker FAQ</a> </li> <li class="menu-item menu-item--l3"> <a href="/files/document/agent/broker-help-desks.pdf" class="menu-item-element" aria-current="false" data-drupal-link-system-path="media/112386">Marketplace help desk & call centers</a> </li> <li class="menu-item menu-item--l3"> <a href="https://data.healthcare.gov/ffm_ab_registration_lists" class="menu-item-element" aria-current="false">Registration Completion List</a> </li> <li class="menu-item menu-item--l3"> <a href="https://data.healthcare.gov/ab-registration-tracker/" class="menu-item-element" aria-current="false">Marketplace Registration Tracker</a> </li> <li class="menu-item menu-item--l3"> <a href="https://data.healthcare.gov/ab-suspension-and-termination-list" class="menu-item-element" aria-current="false">AB Suspension & Termination List</a> </li> <li class="menu-item menu-item--l3"> <a href="https://localhelp.healthcare.gov/" class="menu-item-element" aria-current="false">Find local help</a> </li> <li class="menu-item menu-item--l3"> <a href="https://data.healthcare.gov/issuer-partner-lookup" class="menu-item-element" aria-current="false">Issuer and direct enrollment partner directory</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/help-on-demand" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193196">Help on demand</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/shop-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193096">SHOP Resources</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Health Plans & Issuers</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/health-plans-issuers/qualified-health-plan-certification" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191371">Qualified health plan certification </a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/health-plans-issuers/summary-benefits-coverage" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191461">Summary of benefits & coverage</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/health-plans-issuers/insurance-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192101">Insurance programs</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/health-plans-issuers/premium-stabilization-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191326">Premium stabilization programs</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/health-plans-issuers/insurance-market-reforms" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191421">Health insurance market reforms</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/health-plans-issuers/minimum-essential-coverage" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192891">Minimum essential coverage</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace-private-insurance/health-plans-issuers/pbm-drug-pricing-review" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2088761">Drug pricing & rebate review</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Employers & sponsors</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/small-businesses/other-coverage" class="menu-item-element" aria-current="false">Coverage</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/small-businesses/choose-and-enroll/shop-marketplace-overview" class="menu-item-element" aria-current="false">Regulation & guidance</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/small-businesses/choose-and-enroll/qualify-for-shop-marketplace" class="menu-item-element" aria-current="false">Small business tax credit & premium assistance</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/small-businesses/choose-and-enroll/appeal-a-shop-decision" class="menu-item-element" aria-current="false">Appeals</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/employers-sponsors/small-business-health-options-program-shop" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192901">Small Business Health Options Program (SHOP)</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/employers-sponsors/early-retiree-reinsurance-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191651">Early retiree reinsurance program</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/employer-initiatives" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192916">Employer initiatives</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">States</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/state-marketplace-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190916">Planning & establishing a Marketplace</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/territory-cooperative-agreements" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190926">Territory cooperative agreements</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/early-innovator-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191691">Early innovator program</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/state-flexibility-stabilize-market" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193246">State flexibility to stabilize the Market </a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/creating-competitive-marketplace" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192231">Exchange establishment grants</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/coverage/pre-existing-conditions" class="menu-item-element" aria-current="false">Pre-existing condition insurance plan</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Resources</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/about-us" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192721">About Us</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/resources/data" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191741">Data resources</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/forms-reports-other" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190966">Forms, reports, & other resources</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/letters" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191646">Letters</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/regulations-guidance" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191366">Regulations & Guidance</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/training" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191466">Training resources</a> </li> </ul> </div> </div> </li> </ul> </div> </li> <li class="menu-item menu-item--l1 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Priorities</span> <div class="subnav-wrapper--1 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-main ds-u-lg-display--none">Back to main menu</span> <h2 class="subnav-title-h2" style="position:relative;text-align:left;width:auto;height:auto;">section title h2</h2> </div> <ul class="menu"> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Innovation Center</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/priorities/innovation/overview" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2090631">Overview</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation/about" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2074091">About</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation/key-concepts" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072461">Key Concepts</a> </li> <li class="menu-item menu-item--l3"> <a href="/priorities/innovation-center/model-data" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2087691">Model Data</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation-center/value-based-care-spotlight" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2082926">Value-Based Care Spotlight</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation/models" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072436">Innovation Models</a> </li> <li class="menu-item menu-item--l3"> <a href="/priorities/innovation/where-innovation-happening" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072451">Where Innovation is Happening</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation/evaluation-research-reports" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072446">Evaluations & Research Reports</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Health Equity</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/health-equity/c2c" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1974361">Coverage to Care</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/health-equity/minority-health" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1620916">Minority health</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/health-equity/c2c/es" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072591">Cobertura de atención</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/health-equity/grants-awards" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1612961">Grants & awards</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Recent Legislation</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/inflation-reduction-act-and-medicare" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1621896">Inflation Reduction Act and Medicare</a> </li> <li class="menu-item menu-item--l3"> <a href="/nosurprises" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1573261">No Surprises Act</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Key Initiatives</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a 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class="menu-item-element" aria-current="false">Marketplace Open Enrollment</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/key-initiatives/e-health" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171276">E-health</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/key-initiatives/open-payments" title="Open Payments landing page" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/188426">Open Payments</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/index.html" class="menu-item-element" aria-current="false">Returning to regular operations after COVID-19</a> </li> <li class="menu-item menu-item--l3"> <a href="/priorities/key-initiatives/healthplan-price-transparency" class="menu-item-element" 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page-title"><span class="field field--name-title field--type-string field--label-hidden">Reporting Fraud <div class="title-border"></div></span> </h1> <div class="title-border"></div> </div> </div> </div> </div> </div> </div> <div id="block-cms-evo-content" class="block block-system block-system-main-block"> <div class="content"> <span class="create-date"> </span> <div class="node node--type-content-page node--view-mode-full clearfix"> <div class="node__content clearfix"> <div class="subsite_body"> <div class="layout--twocol-section--25-75 layout--constrained section--bg-style-none section--bg-color-none layout layout--twocol-section top"> <div class="ds-l-container"> <div class="ds-l-row"> <div class="layout__column ds-l-col--12 cms-global-center"> <div class="block block-layout-builder block-field-blocknodecontent-pagebody"> <div class="content"> <span class="create-date"> </span> <div class="field field--name-body field--type-text-with-summary field--label-hidden field__item"><div class="ds-u-margin-bottom--4"><div class="ds-u-padding-left--0 ds-u-padding-right--0 ds-u-padding-top--3 ds-u-padding-bottom--3 ds-u-lg-padding--3"><div class="ds-u-margin--2 ds-u-text-align--center"><h1><span class="ds-u-color--primary-darker ds-u-font-size--h2 ds-u-font-weight--normal ds-u-lg-font-size--h1 ds-u-sans ds-u-text-transform--uppercase">Reporting Fraud</span></h1></div></div><div class="ds-l-row ds-u-justify-content--center ds-u-margin-left--auto ds-u-margin-right--auto ds-u-text-align--center ds-u-color--primary-darker ds-u-margin-left--0 ds-u-lg-margin-top--2"><div class="ds-l-col--12 ds-l-md-col--3 ds-u-padding--0 ds-u-padding-bottom--4"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-general-public-providers-reporting-fraud-icon.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-02/For-general-public-%26-providers-Report.png" width="130" height="130" alt="Clipboard" title="For General Public & Providers " loading="lazy"> </div> </article> </div><div class="ds-u-text-transform--uppercase"><a href="#GeneralPublic">For General Public & Providers</a></div></div><div class="ds-l-col--12 ds-l-md-col--3 ds-u-padding--0 ds-u-padding-bottom--4"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-providers-icon-reporting-fraud.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-02/Providers.png" width="130" height="130" alt="Providers " title="Providers " loading="lazy"> </div> </article> </div><div class="ds-u-text-transform--uppercase"><a href="#Providers">Providers Identity Theft</a></div></div><div class="ds-l-col--12 ds-l-md-col--3 ds-u-padding--0 ds-u-padding-bottom--4"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-people-medicare-reporting-fraud-menu-icon.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-02/For-people-with-medicare.png" width="130" height="130" alt="For People With Medicare" title="For People With Medicare" loading="lazy"> </div> </article> </div><div class="ds-u-text-transform--uppercase"><a href="#ForPeople">FOR PEOPLE WITH MEDICARE</a></div></div><div class="ds-l-col--12 ds-l-md-col--3 ds-u-padding--0 ds-u-padding-bottom--4"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-parents-or-guardians-children-chip-reporting-fraud-icon.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-02/For-Parents-%26-Guardians-of-Children-with-Chip.png" width="130" height="130" alt="Man, Woman, and child" title="For Parents or Guardians with Children with CHIP" loading="lazy"> </div> </article> </div><div class="ds-u-text-transform--uppercase"><a href="#ForParents">For PARENTS OR GUARDIANS OF Children with chip</a></div></div></div><p>Anyone suspecting healthcare fraud, waste or abuse is encouraged to report it. Find out how and where to report. Start by choosing the option that best describes your situation:</p><p> </p><div class="ds-l-container preview__grid ds-u-border--2 ds-u-md-padding--2" id="GeneralPublic"><div class="ds-l-row ds-u-md-margin--2 ds-u-padding--2"><div class="ds-l-col--12 ds-u-text-align--center"><p class="ds-u-color--primary-darker ds-u-font-weight--bold ds-u-font-size--h3">For General Public & Providers - Report About Medicare & Medicaid:</p><div class="ds-l-row"><div class="ds-l-l-col--3 ds-l-xl-col--3 ds-l-md-col--6 ds-l-sm-col--12"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/about-cms/components/cpi/images/phone.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_phone.png" width="130" height="130" alt="Phone" loading="lazy"> </div> </article> </div><p class="ds-u-font-size--h4 ds-u-font-weight--bold ds-u-padding-top--2 ds-u-color--primary-darker">By Phone</p><p>Health & Human Services Office of the Inspector General</p><p>1-800-HHS-TIPS<br>(1-800-447-8477)<br>TTY: 1-800-377-4950</p></div><div class="ds-l-l-col--3 ds-l-xl-col--3 ds-l-md-col--6 ds-l-sm-col--12"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-laptop-large-icon.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_Online.png" width="130" height="130" alt="Laptop" loading="lazy"> </div> </article> </div><p class="ds-u-font-size--h4 ds-u-font-weight--bold ds-u-padding-top--2 ds-u-color--primary-darker">Online</p><p><a href="https://oig.hhs.gov/FRAUD/REPORT-FRAUD/INDEX.ASP">Health & Human Services Office of the Inspector General Website</a></p></div><div class="ds-l-l-col--3 ds-l-xl-col--3 ds-l-md-col--6 ds-l-sm-col--12"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-large-fax-icon.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_fax.png" width="130" height="130" alt="Fax Machine" loading="lazy"> </div> </article> </div><p class="ds-u-font-size--h4 ds-u-font-weight--bold ds-u-padding-top--2 ds-u-color--primary-darker">By Fax</p><p class="ds-u-font-style--italic">Maximum of 10 pages</p><p>1-800-223-8164</p></div><div class="ds-l-l-col--3 ds-l-xl-col--3 ds-l-md-col--6 ds-l-sm-col--12"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-large-mail-icon-reporting-fraud.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_mail.png" width="130" height="130" alt="Envelope " loading="lazy"> </div> </article> </div><p class="ds-u-font-size--h4 ds-u-font-weight--bold ds-u-padding-top--2 ds-u-color--primary-darker">By Mail</p><p>Office of Inspector General<br>ATTN: OIG HOTLINE OPERATIONS<br>P.O. Box 23489<br>Washington, DC 20026</p></div></div></div></div></div><div class="ds-l-container preview__grid ds-u-border--2 ds-u-padding--0 ds-u-margin-top--4" id="Providers"><div class="ds-l-row ds-u-padding--2"><div class="ds-l-col--12 ds-l-md-col--3 ds-u-padding--2 ds-u-text-align--center ds-u-md-text-align--left"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-laptop-large-icon.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_Online.png" width="130" height="130" alt="Laptop" loading="lazy"> </div> </article> </div></div><div class="ds-l-col--12 ds-l-md-col--9 ds-u-text-align--left ds-u-lg-padding--2 ds-u-text-align--center ds-u-md-text-align--left"><p class="ds-u-lg-margin-bottom--0 ds-u-font-size--h3 ds-u-font-weight--bold ds-u-valign--middle ds-u-color--primary-darker ds-u-lg-padding--2">Providers – Do you suspect your identity has been stolen?<br><br><a class="ds-u-font-size--small ds-u-font-weight--bold ds-u-font-weight--normal" href="/about-cms/components/cpi/victimizedproviderproject" title="Victimized Provider Project" data-entity-type="node" data-entity-uuid="ffcb3b3d-a446-475c-933f-8fd67c3464c8" data-entity-substitution="canonical">Get information on how CMS can help through the Victimized Provider Project</a>.</p></div></div></div><div class="ds-l-container preview__grid ds-u-border--2 ds-u-margin-top--4 ds-u-padding--2" id="ForPeople"><div class="ds-l-row ds-u-md-margin--2 ds-u-md-padding--2"><div class="ds-l-col--12 ds-u-text-align--left"><p class="ds-u-font-size--h3 ds-u-font-weight--bold ds-u-padding-bottom--2 ds-u-color--primary-darker ds-u-padding-top--2">For People with Medicare:</p></div><div class="ds-l-col--12 ds-u-text-align--center ds-u-color--primary-darker"><p class="ds-u-padding-bottom--2 ds-u-margin-bottom--4 ds-u-font-size--h4 ds-u-font-weight--bold ds-u-color--primary-darker">Medicare Parts A & B, C, D Information</p><div class="ds-l-row ds-u-padding-bottom--4"><div class="ds-l-md-col--4 ds-l-l-col--4 ds-l-xl-col--4 ds-l-sm-col--12"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/about-cms/components/cpi/images/phone.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_phone.png" width="130" height="130" alt="Phone" loading="lazy"> </div> </article> </div><p class="ds-u-font-size--h3 ds-u-font-weight--bold ds-u-color--primary-darker ds-u-padding-top--2 ds-u-padding-bottom--2">Medicare Parts A & B</p><p class="ds-u-font-size--h4 ds-u-font-weight--bold">By Phone</p><p class="ds-u-color--black">1-800-MEDICARE<br>(1-800-633-4227)<br>TTY: 1-877-486-2048</p></div><div class="ds-l-md-col--4 ds-l-l-col--4 ds-l-xl-col--4 ds-l-sm-col--12"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-file-icon-reporting-fraud-page.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_Medicare-Part-C.png" width="130" height="130" alt="Document" loading="lazy"> </div> </article> </div><p class="ds-u-font-size--h3 ds-u-font-weight--bold ds-u-color--primary-darker ds-u-padding-top--2">Medicare Part C<br><span class="ds-u-color--black ds-u-font-size--base ds-u-font-weight--normal">(Medicare Advantage)</span></p><p class="ds-u-font-size--h4 ds-u-font-weight--bold">Varies by plan</p><p class="ds-u-color--black">Refer to your plan's general contact and/or fraud-reporting information</p></div><div class="ds-l-md-col--4 ds-l-l-col--4 ds-l-xl-col--4 ds-l-sm-col--12"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/about-cms/components/cpi/images/phone.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_phone.png" width="130" height="130" alt="Phone" loading="lazy"> </div> </article> </div><p class="ds-u-font-size--h3 ds-u-font-weight--bold ds-u-padding-top--2">Medicare Part D<br><span class="ds-u-color--black ds-u-font-size--base ds-u-font-weight--normal">(Medicare Drug Plan)</span></p><p class="ds-u-font-size--h4 ds-u-font-weight--bold">By Phone</p><p class="ds-u-color--black">1-877-7SAFERX<br>(1-877-772-3379)<br>OR<br>refer to your plan’s general contact and/or fraud-reporting information</p></div></div><div class="ds-l-col--12 ds-u-text-align--center ds-u-padding-top--4 ds-u-padding-bottom--2 ds-u-border-top--2"><p class="ds-u-font-size--h3 ds-u-font-weight--bold ds-u-color--primary-darker ds-u-leading--base">If You'd Like Assistance Reporting Suspected Fraud, the Senior Medicare Patrol (SMP) is Here to Help. Call or Locate Your Local SMP Online.</p></div><div class="ds-l-row"><div class="ds-l-md-col--6 ds-l-l-col--6 ds-l-xl-col--6 ds-l-sm-col--12"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/about-cms/components/cpi/images/phone.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_phone.png" width="130" height="130" alt="Phone" loading="lazy"> </div> </article> </div><p class="ds-u-font-size--h4 ds-u-font-weight--bold ds-u-padding-top--2">By Phone</p><p class="ds-u-color--black">1-877-808-2468</p></div><div class="ds-l-md-col--6 ds-l-l-col--6 ds-l-xl-col--6 ds-l-sm-col--12"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-laptop-large-icon.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_Online.png" width="130" height="130" alt="Laptop" loading="lazy"> </div> </article> </div><p class="ds-u-font-size--h4 ds-u-font-weight--bold ds-u-padding-top--2">Online</p><p class="ds-u-color--black"><a href="https://www.smpresource.org/">Senior Medicare Patrol Website</a></p></div></div></div></div></div><div class="ds-u-margin-bottom--6 ds-l-container preview__grid ds-u-border--2 ds-u-margin-top--4 ds-u-padding--2" id="ForParents"><div class="ds-l-row ds-u-md-margin--2 ds-u-md-padding--2"><div class="ds-l-md-col--6 ds-l-l-col--6 ds-l-xl-col--6 ds-l-sm-col--12 ds-u-text-align--center"><p class="ds-u-font-size--h4 ds-u-font-weight--bold ds-u-color--primary-darker ds-u-padding-top--2">For Parents or Guardians of<br>Children with CHIP:</p><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-laptop-large-icon.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_Online.png" width="130" height="130" alt="Laptop" loading="lazy"> </div> </article> </div><p class="ds-u-color--primary-darker ds-u-font-size--h4 ds-u-font-weight--bold ds-u-padding-top--2">Online</p><p><a href="https://www.insurekidsnow.gov/coverage/index.html">Look up your state’s CHIP resources</a>, then search for reporting fraud on the corresponding website.</p></div><div class="ds-l-md-col--6 ds-l-l-col--6 ds-l-xl-col--6 ds-l-sm-col--12 ds-u-text-align--center"><p class="ds-u-font-size--h4 ds-u-font-weight--bold ds-u-color--primary-darker ds-u-padding-top--2">For General Public - Report About the Health Insurance Marketplace:</p><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/about-cms/components/cpi/images/phone.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_phone.png" width="130" height="130" alt="Phone" loading="lazy"> </div> </article> </div><p class="ds-u-color--primary-darker ds-u-font-size--h4 ds-u-font-weight--bold ds-u-padding-top--2">By Phone</p><p>1-800-318-2596<br>TTY: 1-855-889-4325</p></div></div></div><div class="ds-u-padding-x--0 ds-u-padding-top--2 ds-u-margin-x--0 ds-u-margin-y--2"><p class="ds-u-font-size--h3 ds-u-text-transform--uppercase">Stay Up to Date with CPI</p><p>Connect with CPI as we host or attend various events throughout the year, join our mailing list to stay informed on Program Integrity news, or find the most appropriate vehicle to report suspected fraud, waste, or abuse.</p></div><div class="ds-l-row ds-u-text-align--center ds-u-margin--2"><div class="ds-l-col--12 ds-l-md-col--4 ds-u-padding-2"><div class="ds-u-padding--1 ds-u-color--primary-darker ds-u-font-size--small"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-landing-page-events-icon.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_events.png" width="80" height="80" alt="Events Calendar Icon" loading="lazy"> </div> </article> </div><p><a class="ds-u-color--primary-darker ds-u-text-decoration--none" href="/medicare/medicaid-coordination/center-program-integrity/events" title="See Upcoming CPI Events" data-entity-type="node" data-entity-uuid="0373381a-467d-43b9-ae17-066b50852cca" data-entity-substitution="canonical">Join us at the next event - check out the Events page to see where we'll be next!</a></p></div></div><div class="ds-l-col--12 ds-l-md-col--4 ds-u-padding-2"><div class="ds-u-padding--1 ds-u-color--primary-darker ds-u-font-size--small"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-landing-page-news-letter-icon.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_newsletter.png" width="80" height="80" alt="News Letter " loading="lazy"> </div> </article> </div><p><a class="ds-u-color--primary-darker ds-u-text-decoration--none" href="https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_12361" title="Sign up for the CPI Provider Compliance newsletter">Sign up for our Provider Compliance Newsletter to learn about events and other compliance news.</a></p></div></div><div class="ds-l-col--12 ds-l-md-col--4 ds-u-padding-2"><div class="ds-u-padding--1 ds-u-color--primary-darker ds-u-font-size--small"><div class="embedded-entity"><article class="align-center media media--type-image media--view-mode-embedded"> <div mid="/files/image/cpi-landing-page-report-icon.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2023-01/2023-icons_report.png" width="80" height="80" alt="Report" loading="lazy"> </div> </article> </div><p><a class="ds-u-color--primary-darker ds-u-text-decoration--none" href="/medicare/medicaid-coordination/center-program-integrity/reporting-fraud" title="Report suspected fraud, waste, or abuse" data-entity-type="node" data-entity-uuid="ae3a02ad-ddfb-463c-ae6a-7f289aa497b4" data-entity-substitution="canonical">Report suspected fraud, waste, or abuse.</a></p></div></div></div></div></div> </div> </div> </div> </div> </div> </div> <div class="layout--constrained section--bg-style-none section--bg-color-none layout layout--onecol-section"> <div class="ds-l-container"> <div class="ds-l-row"> <div class="layout__column ds-l-col--12 cms-global-center"> </div> </div> </div> </div> </div> <div class="layout--onecol-section"> <div class="ds-l-container"> <div class="ds-l-row"> <div class="ds-l-col--12"> <div class="changed-date-block"> <div class="changed-date-decorative-bar" aria-hidden="true"></div> <div class="changed-date"> <div class="field__label">Page Last Modified:</div> <div class="field__item">09/10/2024 06:18 PM</div> </div> <div class="help-link"> <a href="/node/169881" title="Help with File Formats and Plug-Ins" class="file-format-help">Help with File Formats and Plug-Ins</a> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </inner> </div> </div> </div> </main> </div> </div> <!-- footer --> <footer class="cms--footer ds-u-padding-y--3 ds-u-lg-padding-y--5 ds-u-margin-top--4"> <div class="ds-l-container"> <div class="ds-l-row ds-u-justify-content--center footer-email-section"> <div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--8"> <h2>Get email updates</h2> <p>Sign up to get the latest information about your choice of CMS topics. 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