Updates of Chapter 1, Chapter 2, Chapter 3, Chapter 4, and Appendices in Publication (Pub.) 100-15, Including Auditing of Program Integrity Activities in Managed Care Plans
The purpose of this Change Request (CR) is to update sections within Chapter 1, Chapter 2, Chapter 3, Chapter 4, and Appendices in Pub. 100-15. The updates in this CR include, but are not limited to, Unified Program Integrity Contractor (UPIC) auditing of program integrity activities in Managed Care Plans, guidance regarding support to states on appeals, guidance regarding proactive project development, and various other minor updates to Pub 100-15.
This update does not affect the provider and/or beneficiary populations. Rather, this update is solely related to contractor technical processes and procedures. All updates ensure our contractors have the most recent guidance. This CR does not require Provider Education.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: October 11, 2024
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.