Overview of Program Integrity and Provider Compliance

1.1- Overview of Program Integrity and Provider Compliance (Rev. 10365; Issued: 10-02-20; Effective: 08-27-20; Implementation: 08-27-20) The term “Review Contractor” throughout the Program Integrity Manual refers to: • Medicare Administrative Contractors (MACs) • Comprehensive Error Rate Testing (CERT) contractors • Recovery Auditors • Unified Program Integrity Contractors (UPICs) • Supplemental Medical Review Contractor (SMRC) Review Contractors shall follow all sections of the PIM unless otherwise indicated as required by their applicable Statements of Work (SOW).