Program Integrity Manual Updated for Identity Theft and Hospice Aggregate Cap Liability

The Centers for Medicare & Medicaid Services (CMS) recently released a new transmittal that updates the chapter of the Program Integrity Manual to address coordination between Medicare Administrative Contractors (MAC) and Unified Program Integrity Contractors (UPIC) in situations of hospice aggregate cap liabilities, as well as addressing Medicare liabilities in situations of provider identity theft.…

CMS Revises Instructions for Statistical Sampling

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…