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Program Integrity Manual - CMS

Medicare Program Integrity Manual chapter 8 Administrative Actions and Sanctions and Statistical Sampling for Overpayment Estimation Table of Contents (Rev. 11032, 09-30-21) Transmittals for chapter 8 Appeal of Denials Overpayment Procedures Overpayment Assessment Procedures Definition of Overpayment Assessment Terms Assessing Overpayment When Review Was Based on Statistical Sampling for Overpayment Estimation Assessing Overpayment or Potential Overpayment When Review Was Based on Limited Sample or Limited Sub sample Contractor Activities to Support Assessing Overpayment Conduct of Expanded Review Based on Statistical Sampling for Overpayment Estimation and Recoupment of Projected Overpayment by Contractors - Reserved for Future Use - Background

Chapter 8 – Administrative Actions and Sanctions and ... 8.2.3 – Assessing Overpayment or Potential Overpayment When Review Was Based on Limited Sample or Limited Sub–sample. ... They document the sampling methodology when review is based on statistical sampling

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