US · guidance
CMS Pub. 100-08, ch. 1, § 1.3.2
Improper Payment Prevention Goals
The CMS strives in every case to pay the right amount to a legitimate provider, for
covered, correctly coded and correctly billed services, provided to an eligible beneficiary.
To achieve the goal of improving provider compliance and lowering the error rate, CMS
follows three parallel strategies:
• Preventing improper payments through MACs and SMRC evaluation of program
vulnerabilities and taking the necessary action to prevent the identified
vulnerabilities in the future
• Correcting past improper payments through postpayment claim review by the
Recovery Auditors
• Measuring improper payments and pinpointing the causes of improper payments
by calculating service specific, provider type and contractor specific error rates by
the CERT contractors
History
(Rev. 508; Issued: 03-07-14, Effective: 04-08-14, Implementation: 04-08-14)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
51b363add9ec5d658bd143e4067d80a0b9be88fb2de593e638a5bb1fdcf32f7d
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