US · guidance
CMS Pub. 100-04, ch. 27, § 60
Paying Claims Outside of CWF
The CWF approves each claim before it is paid. However, there may be special
circumstances when it is necessary to pay claims outside the CWF/CWF system. The
CMS will notify the A/B MAC or DME MAC of these instances. They include, but may
not be limited to:
• New coverage policies are enacted by Congress with effective dates that preclude
making the necessary changes to CWF timely; and,
• Errors are discovered in CWF that cannot be corrected timely. All A/B MACs
and DME MACs are responsible for reporting CWF problems to their host sites.
History
(Rev. 4009, Issued: 03-23-18, Effective: 04-23-18, Implementation: 04-23-18)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
e5d2c8f67678d24a5d373594c835aad81b6627c875ac19e6dddaee73fde2c0b2
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