Medicare Program Integrity Manual (Pub. 100-08), Ch. 7 § 7.1.2.6.1
Budget and Workload Management
7.1.2.6.1 - Budget and Workload Management
(Rev. 599, Issued: 06-26-15, Effective: 12-07-15, Implementation: 12-07-15)
The IPRS shall include a section that describes the process used to monitor budget and
workload for the MR activities definitions. The process shall ensure that spending is
consistent with the allocated budget and include procedures to revise or amend the plan
when spending is over or under the budget allocation. The MAC shall have a table in the
IPRS identifying the MR workload for the current period of performance.
The MAC shall assess the cost effectiveness of each MR activity and appropriateness of
each MR activity. The MAC shall determine if the resources required for the planned
MR activity can contribute to achieving the reduction of the improper payment error rate.
In addition, the IPRS shall describe how workload for each MR activity is accurately and
consistently reported. The workload reporting process shall also assure the proper
allocation of employee hours required for each MR activity.