Medicare Program Integrity Manual (Pub. 100-08), Ch. 11 § 11.1.3.6
MR Program Management Costs (Activity Code 21207)
11.1.3.6 – MR Program Management Costs (Activity Code 21207)
(Rev. 10365; Issued: 10-02-20; Effective: 08-27-20; Implementation: 08-27-20)
The MR Program Management encompasses managerial responsibilities inherent in
managing the MR program, including: development, modification, and periodic reporting
of MR strategy and quality assurance activities; planning monitoring and adjusting
workload performance; budget-related monitoring and reporting; and implementation of
CMS instructions.
Activity Code 21207 is designed to capture the costs of managerial oversight for the
following tasks:
• Develop and periodically modify MR strategy;
• Develop and modify quality assurance activities, including special studies,
inter- reviewer reliability testing, committee meetings, and periodic reports;
• Evaluate edit effectiveness;
• Plan, monitor and oversee budget, including interactions with contractor
budget staff and RO budget and MR program staff;
• Manage workload, including monitoring of monthly workload
reports, reallocation of staff resources, and shifts in workload focus
when indicated;
• Implement MR instructions from regional and/or central office;
• Educate staff on MR program, new CMS instructions, and quality assurance
findings (this is different from the internal training of MR staff to perform MR
activities); and,
• Support service for UPIC performing MR activities other than for the
CERT contractor.