CMS Revises Instructions for Statistical Sampling

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The Centers for Medicare & Medicaid Services(CMS) has issued Change Request (CR) 10067 which revises instructions to the CMS medical review contractors (Medicare Administrative Contractors (MACs), the Recovery Audit Contractors (RACs), the Supplemental Medical, Review Contractors (SMRCs), and the Unified Program Integrity Contractors (UPICs)) on the use of statistical sampling for overpayment estimations. The revised […]

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CMS Stipulates Credentials of Medical Reviewers

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The Centers for Medicare & Medicaid Services (CMS) released Change Request 10909, which requires that the Medicare medical record review contractors ensure medical review audits are conducted by registered nurses, therapist or physicians. The requirement applies to the Medicare Administrative Contractors (MACs), the Comprehensive error Rate Testing Contractors (CERT), the Recovery Audit Contractors (RACs), the […]

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