Determining Review Site

8.4.6.1.2 - Determining Review Site (Rev. 906; Issued: 09-26-19; Effective: 01-02-19; Implementation: 01-02-19) A. Provider/Supplier Site Reviews Provider/supplier site reviews are performed at the provider’s or supplier’s location(s). Considerations in determining whether to conduct the review at the office of the provider or supplier include, but are not limited to, the following: • The extent of aberrant billing or utilization patterns that have been identified, • The presence of multiple program integrity issues, • Evidence or likelihood of fraud or abuse, and • Past failure(s) of the provider or supplier to submit requested medical records in a timely manner or as requested. B. Contractor Site Reviews The contractor site reviews are performed at a location of the contractor.