Assess whether threshold splitting is a procurement-integrity issue (f0e91d)

Situation

Threshold splitting is a sits with HHS-OIG health-fraud analyst because a IG hotline on split purchases hit a Medicare contractor SIU pack. Evidence is Medicare billing-pattern outlier table; write the US Federal Banking Regulation and Model Risk option that extract can carry.

Decision

HHS-OIG health-fraud analyst in a Medicare contractor SIU pack must choose Pursue / Pursue with conditions / Partner / No-bid using Medicare billing-pattern outlier table after a IG hotline on split purchases.

Hypotheses to test

• Medicare billing-pattern outlier table reads as Pursue once a IG hotline on split purchases is lined up to the same US Federal population.
• Medicare billing-pattern outlier table is closer to Pursue with conditions after a IG hotline on split purchases; Pursue would over-claim this Banking Regulation and Model Risk extract.
• Partner is still live in Medicare billing-pattern outlier table for HHS-OIG health-fraud analyst in a Medicare contractor SIU pack.
• Medicare billing-pattern outlier table is missing the fact HHS-OIG health-fraud analyst needs after a IG hotline on split purchases; stop this US Federal close.

Analysis required

• Normalize pricing and CPARS/QASP evidence that actually supports threshold splitting is a.
• Compare PTW and compliance gates in Medicare billing-pattern outlier table to a pursue / partner / no-bid split.
• Test OCI and SAM.gov status before a Medicare contractor SIU pack commits.
• For this US Federal Banking Regulation and Model Risk file, read Medicare billing-pattern outlier table against a IG hotline on split purchases and write the one fact that would move threshold splitting is a for HHS-OIG health-fraud analyst.

Recommendation

Choose Pursue / Pursue with conditions / Partner / No-bid on this US Federal / Banking Regulation and Model Risk packet (Medicare billing-pattern outlier table after a IG hotline on split purchases). The follow-on Banking Regulation and Model Risk action is what HHS-OIG health-fraud analyst does next: implement the option, assign an owner, and log the missing fact.

Command returns