Termination of Non-Random Prepay Review Rules Effective Jan. 1

The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) required the Centers for Medicare & Medicaid Services (CMS) to establish criteria for its contractors to use for terminating a provider or supplier from non-random prepayment complex medical review. CMS laid out its plans in a final rule in late 2008 that became effective…