US · guidance
CMS Pub. 100-08, ch. 4, § 4.7.7.1
Monitor Compliance
The UPIC shall monitor future claims and related actions of the provider at least 6
months after the UPIC has closed its investigation to ensure the propriety of future
payments. In addition to internal screening of the claims, if previous experience or future
billings warrant, they shall periodically interview a sampling of the provider's patients to
verify that billed services were actually furnished.
If, at the end of a 6-month period, there is no indication of a continuing aberrant pattern,
the UPIC shall discontinue the monitoring.
History
(Rev. 11032; Issued: 09-30-21; Effective: 10-12-21; Implementation: 11-10-21)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
63badfd49609a54a1e4c201ec34d099f750d015279633efa839541f98b3748c1
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