Updates to Chapter 4 in Publication (Pub.) 100-08 – Medicare Program Integrity Manual

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

On April 21, 2022, CMS posted Change Request 12700 – Transmittal 11358 which is effective May 23, 2022.

The purpose of this Change Request (CR) is to update various sections within Chapter 4 in Pub. 100-08. The primary updates in this CR include updating the Medicare Program Integrity Contractor investigative timeliness requirement and removing all references to the Incentive Rewards Program Tracking Database. Additionally, Exhibit 5 – Background Information for Contractor Staff When IRP is Questioned in the Exhibits Chapter of Pub. 100-08 has been revised. This CR does not involve any legislative or regulatory policies.

Disclaimer for manual changes only: The revision date and transmittal number apply only to red italicized material. Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will receive the new/revised information only, and not the entire table of contents.

II. CHANGES IN MANUAL INSTRUCTIONS: (N/A if manual is not updated) R=REVISED, N=NEW, D=DELETED-Only One Per Row.

Chapter 4 begins on page 6 of this 24-page Transmittal/CR.  Watch for the red ink.