US · guidance
CMS Pub. 100-08, ch. 8, § 8.3.2.7
Contractor Suspects Additional Improper Claims
If the payment suspension is in the process of being terminated or has been terminated,
and the UPIC believes that the provider will continue to submit noncovered,
misrepresented, or potentially fraudulent claims, the UPIC shall consider implementing
or recommending other actions as appropriate (e.g., education, prepayment review,
revocation, a new suspension of payment).
History
(Rev. 11529; Issued: 07-28-2022; Effective: 08-30-2022; Implementation: 08-2022)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
46c219c7ee27f6be50fbe8290c8ff80c27cf008aa99ec8377ba82e65ff19a7c2
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