US · guidance
CMS Pub. 100-08, ch. 8, § 8.2.3.3.3
Consent Settlement Offer
After the additional information concerning the medical records for the claims reviewed
have been assessed and if it is still determined that there was an overpayment, the
contractor shall offer the provider or supplier the opportunity to proceed with statistical
sampling for overpayment estimation or a consent settlement. The UPICs and the
contractor medical review units may choose to present the consent settlement letter to the
provider or supplier in a face-to-face meeting. The consent settlement correspondence
shall describe the two options available to the provider or supplier. The provider or
supplier is given 60 days from the date of the correspondence to choose an option. If
there is no response, Option 1 shall be selected by default.
History
(Rev. 10228; Issued: 07-27-20; Effective: 08-27-20; Implementation: 08-27-20)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
6e8978afc717a3911c82a2fa59a8494e4a2ba4b7113fed81e05744b86f2176f7
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