Medicare Program Integrity Manual (Pub. 100-08), Ch. 7 § 7.1.2.7.3
QA for Program Management
7.1.2.7.3 - QA for Program Management
(Rev. 599, Issued: 06-26-15, Effective: 12-07-15, Implementation: 12-07-15)
The MAC shall describe the processes employed to assure accuracy and consistency in
the reporting of spending, workload, and staffing levels. The MAC shall address how to
maintain accuracy in medical review decision-making and IRR assessments and shall
report the results of the IRR for the MR licensed health care professionals and certified
coders participating in the medical review process. Each IPRS, SAR shall contain the
IRR scores for the period of performance covered by that reporting period.