Assess whether a trial site should be referred (924592)

Situation

A Medicare contractor SIU pack cannot treat log sources that were not retained past 30 days as color commentary on Medicare billing-pattern outlier table. OFAC sanctions investigator must close a trial site should be referred from that extract under US Federal / Public Sector Audit Investigations.

Decision

OFAC sanctions investigator in a Medicare contractor SIU pack must choose Pursue / Pursue with conditions / Partner / No-bid using Medicare billing-pattern outlier table after log sources that were not retained past 30 days.

Hypotheses to test

• Log sources that were not retained past 30 days is noise around an already-controlled Public Sector Audit Investigations process in a Medicare contractor SIU pack, given Medicare billing-pattern outlier table.
• Log sources that were not retained past 30 days is the event in Medicare billing-pattern outlier table that forces Pursue for OFAC sanctions investigator under US Federal.
• Medicare billing-pattern outlier table shows a one-file miss after log sources that were not retained past 30 days, not a Public Sector Audit Investigations program failure.
• Medicare billing-pattern outlier table cannot decide a trial site should be referred yet after log sources that were not retained past 30 days; hold is the only US Federal close a Medicare contractor SIU pack can defend.

Analysis required

• 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.
• Map FAR, Section L/M, and evaluator priorities in Medicare billing-pattern outlier table after log sources that were not retained past 30 days.
• For this US Federal Public Sector Audit Investigations file, read Medicare billing-pattern outlier table against log sources that were not retained past 30 days and write the one fact that would move a trial site should be referred for OFAC sanctions investigator.

Recommendation

Choose Pursue / Pursue with conditions / Partner / No-bid on this US Federal / Public Sector Audit Investigations packet (Medicare billing-pattern outlier table after log sources that were not retained past 30 days). The follow-on Public Sector Audit Investigations action is what OFAC sanctions investigator does next: implement the option, assign an owner, and log the missing fact.