US · guidance
CMS Pub. 100-06, ch. 6, § 70.9
Body of Report (Inactive)
A3-3898.9
Line 1 – Opening Pending – The system will pre-fill the number pending from line 8 of
the previous quarter’s report.
Line 2 – Adjustments – If it is necessary to revise the pending figure for the close of the
previous quarter because of inventories, reporting errors, etc., enter the adjustment on this
line. Precede negative adjustments with a minus sign.
Line 3 – Adjusted Pending – The system will sum line 1 + line 2 to calculate the
adjusted opening pending.
Line 4 – Workload Received – The intermediary reports the number of complaints and
referrals received in the fraud unit during the reporting period.
Line 5 – Total Cleared – The system will sum line 6 + line 7 to calculate the total
number of complaints and referrals cleared by the fraud unit during the reporting period.
Line 6 – Cleared by Contractor – The intermediary reports the number of complaints
and referrals cleared by the fraud unit by means other than referral to the OIG or
designated agency. Include those that were:
• Closed as not substantive or not a fraud issue.
• Closed as not a fraud issue but referred to another contractor component for their
review or action.
• Closed as not being a fraud issue but referred to an external component other than
the OIG.
Line 7 – Cleared by Referral – The intermediary reports the number of complaints and
referrals that were incorporated into cases referred formally to the OIG or designated
agency for action (e.g., sanctions or prosecution).
Line 8 – Closing Pending – The system will calculate the closing pending for the quarter
by adding line 3 to line 4 and subtracting line 5.
70.10 – Completing Quarterly Periodic Interim Payment (PIP) Report,
CMS-1566C – General
(Rev12894; Issued:10-17-24-Effective: 11-01-24; Implementation:11-01-24)
A3-3898.10
The intermediary prepares and submits to CMS each quarter a report on the number of
providers that you pay using the PIP method. This information is required so that CMS
can monitor the number of providers being paid using the PIP method at each
intermediary and nationally. Submit the form via CROWD no later than the 15th day
following the close of the reporting quarter.
History
(Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
c7dd371b893c89f943acceadce0ff7a650482a321106ede088e695ae55fd55fe
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