Medicare Program Integrity Manual (Pub. 100-08), Ch. 8 § 8.4.9

Changes Resulting From Appeals

Last amended: 2019Year: 2019Length: 85 wordsOfficial source
8.4.9 - Changes Resulting From Appeals (Rev. 906; Issued: 09-26-19; Effective: 01-02-19; Implementation: 01-02-19) If the decision issued on appeal contains either a finding that the sampling methodology was invalid or reverses the revised initial claim determination, the contractor shall take appropriate action to adjust the estimation of overpayment with the revised input of the statistical expert who created the initial methodology or the revised input of another statistical expert supplied by the contractor should the creator of the initial methodology no longer be available.
Medicare Program Integrity Manual (Pub. 100-08), Ch. 8 § 8.4.9: Changes Resulting From Appeals | Justis AI