Medicare Program Integrity Manual (Pub. 100-08), Ch. 11 § 11.1.4.1

MIP CERT Support (Activity Code 21901)

Last amended: 2007Year: 2007Length: 310 wordsOfficial source
11.1.4.1 - MIP CERT Support (Activity Code 21901) (Rev. 220, Issued: 08-24-07, Effective: 09-03-07, Implementation: 09-03-07) Report the costs associated with time spent on MIP CERT Support Activities. These activities include but are not limited to the following: o Providing review information to the CERT contractor as described in IOM Pub. 100-08, ch.12 § 3.3.2. o Providing feedback information to the CERT contractor as described in IOM Pub. 100-08, ch.12, § 3.3.3 including but not limited to: + CMD discussions about CERT findings; + Participation in biweekly CERT conference calls; + Responding to inquiries from the CERT contractor; and + Preparing dispute cases. o Preparing the Error Rate Reduction Plan (ERRP) as described in IOM Pub..100- 08, ch. 12, §3.9 (Do not include costs of developing MR Strategy or the Quarterly Strategy Analysis (QSA). The cost of developing the MR Strategy and QSA shall be captured in MR CAFM code 21207). o Educating the provider community about CERT as described in IOM Pub. 100- 08, ch.12, § 3.8. o Contacting non-responders and referring recalcitrant non-responders to the OIG as described in IOM Pub. 100-08, ch.12, § 3.10. Contractors shall NOT report costs associated with the following activities in this activity code: • Providing sample information to the CERT Contractor as described in IOM Pub. 100-08, ch. 12, §3.3.1A&B (these costs should be allocated to the PM CERT Support Code – 12901 -- described in the Appeals BPR); • Ensuring that the correct provider address is supplied to the CERT Contractor as described in IOM Pub. 100-08, ch. 12, §3.3.1.C (these costs should be allocated to the PM CERT Support Code – 12901 -- described in the Appeals BPR); Researching ‘no resolution’ cases as described in IOM Pub. 100-08, ch. 12, §3.3.1.B (these costs should be allocated to the PM CERT Support Code – 12901 -- described in the Appeals BPR).
Medicare Program Integrity Manual (Pub. 100-08), Ch. 11 § 11.1.4.1: MIP CERT Support (Activity Code 21901) | Justis AI