Medicare Program Integrity Manual (Pub. 100-08), Ch. 1 § 1.3.4
Performance Metrics
1.3.4 - Performance Metrics
(Rev. 508; Issued: 03-07-14, Effective: 04-08-14, Implementation: 04-08-14)
A. MAC MR Units Performance
The MAC MR Unit performance is measured by:
• CERT: CERT is a CMS program that measures a contractor’s payment error
rate.
• In addition, the MACs are measured by other measures listed in the MAC SOW.
B. Recovery Auditor Performance:
One key measure of Recovery Auditor performance is the Recovery Auditor accuracy
rate. CMS will produce a Recovery Auditor accuracy rate for each Recovery Auditor on
an annual basis. These rates will be released to the public through the annual Report to
Congress.
C. CERT Performance
The CERT performance metrics are listed in the contractors’ SOW. One key measure of
CERT performance is the timely production of the national error rate each year.
D. SMRC
A performance measure of the SMRC contractor is the accuracy rate. This will be
coordinated by CMS annually. Additional performance measures are listed in their SOW.