Medicare Program; termination of non-random prepayment complex medical review. Final rule.
This final rule implements requirements regarding the termination of non-random prepayment complex medical review as required under the Medicare Prescription Drug, Improvement and Modernization Act of 2003. This final rule sets forth the criteria CMS contractors will use for terminating a provider or supplier from non-random prepayment complex medical review.
D003284:Contract Services / Q000331:legislation & jurisprudence*; D005607:Fraud / Q000517:prevention & control; D006801:Humans; D007345:Insurance Claim Review / Q000331:legislation & jurisprudence*; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence*; D006278:Medicare / Q000331:legislation & jurisprudence*; D012051:Reimbursement Mechanisms / Q000331:legislation & jurisprudence*; D014481:United States