Medicare Program Integrity Manual (Pub. 100-08), Ch. 8 § 8.4.4.3
Determining Sample Size
8.4.4.3 - Determining Sample Size
(Rev. 11962; Issued: 04-21-23; Effective: 05-22-23; Implementation: 05-22-23)
The size of the sample (i.e., the number of sampling units constituting the sample) will
have a direct bearing on the precision of the estimated overpayment, but it is not the only
factor that influences precision. It is neither possible nor desirable to specify a minimum
sample size that applies to all situations.
In addition to the above considerations, real-world economic constraints shall be taken
into account. As stated earlier, sampling is used when it is not administratively feasible
to review the entire target population. In determining the sample size to be used, the
contractor shall also consider its available resources. That does not mean, however, that
the resulting estimate of overpayment is not valid, so long as proper procedures for the
execution of probability sampling and overpayment estimation have been followed.
Some challenges to the validity of the sample that are sometimes made include whether --
(1) The probability sample was chosen and drawn in a statistically appropriate way from
the target population or (2) The particular sample size is too small to yield meaningful
results. Such challenges are without merit when presented in isolation from any
reference to the actual sampling methodology used, and when presented without a
complete account of the actual sampling methodology used.