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US · guidance

CMS Pub. 100-08, ch. 8, § 8.4.9

Changes Resulting From Appeals

activein force · 2026-08-25 – presentas-observed

If the decision issued on appeal contains either a finding that the sampling methodology

was invalid or reverses the revised initial claim determination, the contractor shall take

appropriate action to adjust the estimation of overpayment with the revised input of the

statistical expert who created the initial methodology or the revised input of another

statistical expert supplied by the contractor should the creator of the initial methodology

no longer be available.

History

(Rev. 906; Issued: 09-26-19; Effective: 01-02-19; Implementation: 01-02-19)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
bdce0ef9ea967010b8790d0d700fdfe2f5cee91f91b01e6e81aed624dd072718
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