Medicare Program Integrity Manual (Pub. 100-08), § 2.6
Dispute Resolution Process
Length: 202 wordsOfficial source
2.6-Dispute Resolution Process
Disputes/issues will be escalated, if necessary, for resolution by the following process:
1. The SMRC and the UPIC counterparts will first attempt to resolve the issue.
2. If the SMRC and the UPIC counterparts are unable to come to a resolution, the matter will
be brought to the attention of the SMRC JOA POC and the UPIC JOA POC (as identified in
Appendix A, Master Contact List).
3. If the SMRC JOA POC and the UPIC JOA POC are unable to come to a resolution, the
matter will be escalated to the SMRC PM and the UPIC Project Manager (as identified in
Appendix A, Master Contact List).
4. If the SMRC PM and the UPIC Project Manager are unable to come to a resolution, the
SMRC PM will bring this matter to the attention of the SMRC CMS COR and the UPIC
Project Manager will bring this matter to the attention of the UPIC CMS COR (as identified
in Appendix A, Master Contact List).
5. If the dispute between the SMRC and the UPIC cannot be resolved, the issues will be
directed, in writing, to the CMS CORs and BFLs for resolution by a JOA Alternative
Dispute Resolution Team.