Medicare Program Integrity Manual (Pub. 100-08), Ch. 8 § 8.4.6.1
Notification of Provider or Supplier of the Review and
8.4.6.1 – Notification of Provider or Supplier of the Review and
Selection of the Review Site
(Rev. 906; Issued: 09-26-19; Effective: 01-02-19; Implementation: 01-02-19)
The contractor shall first determine whether it will be giving advance notification to the
provider or supplier of the review. Although in most cases the contractor conducting the
review shall give prior notification, the provider/supplier is not always notified before the
start of the review. When not giving advance notice, the contractor shall obtain the
advance approval of the BFL/COR. When giving advance notice, the contractor shall
provide written notification by certified mail with return receipt requested (retain all
receipts).
Second, regardless of whether advance notice is provided, the contractor shall determine
where to conduct the review of the medical and other records: either at the
provider’s/supplier’s site(s) or at the contractor’s office.