Medicare Program Integrity Manual (Pub. 100-08), Ch. 1 § 1.3.10

Coordination Among Contractors

Last amended: 2020Year: 2020Length: 138 wordsOfficial source
1.3.10 – Coordination Among Contractors (Rev. 10365; Issued: 10-02-20; Effective: 08-27-20; Implementation: 08-27-20) A. Coordination among MACs and UPICs The MAC MR staff shall coordinate and communicate with their associated UPIC to ensure coordination of efforts and to prevent inappropriate duplication of review activities. At any time, suspicion of fraud should result in referral to the UPIC for development. B. Coordination among MACs and the Recovery Auditors See Pub. 100-06, Financial Management Manual, chapter 4, section 100.1-100.15, for a description of the coordination efforts between MACs and Recovery Auditors. In addition, the MACs shall coordinate and communicate with the Recovery Auditors to get the specifics on Recovery Auditor identified vulnerabilities for use in the MAC’s data analysis and possible corrective actions. C. SMRC The SMRC shall make all recommendations for referrals through their CMS Contract Officer Representative (COR).
Medicare Program Integrity Manual (Pub. 100-08), Ch. 1 § 1.3.10: Coordination Among Contractors | Justis AI