US · guidance
CMS Pub. 100-08, ch. 12, § 12.11
Late Documentation Received by the CERT Review Contractor
This section applies to Medicare Administrative Contractors (MACs) and Comprehensive
Error Rate Testing (CERT) as indicated.
The MACs may submit any additional documentation received from the provider or
supplier to the CERT review contractor for consideration as late documentation.
If the CERT review contractor receives late documentation before the review decision is
posted on the C3HUB, the CERT review contractor reviews the late documentation and
scores the claim appropriately. If the CERT review contractor receives late
documentation after the review decision has been posted on the C3HUB, the CERT
review contractor checks to see if the MAC has entered an appeal in the C3HUB. If the
MAC has entered an appeal for the CERT-initiated denial in the C3HUB, the CERT
review contractor does not review the late documentation. If the MAC has not entered an
appeal for the CERT-initiated denial in the C3HUB, the CERT review contractor reviews
the late documentation and scores the claim appropriately. If the late documentation is
received before the cutoff date to receive late documentation for the report (in time to
complete review before the cutoff dates for the report) it is included in that year’s
improper payment rate calculation.
The MAC shall notify the provider of the change in denial reason. These cases are
included in the feedback section of the C3HUB.
History
(Rev. 13678; Issued: 03-12-26; Effective: 04-13-26; Implementation: 04-13-26)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
9e1f8aff5473f84927cdb222d21f59e32f68f1d8856429bde071e8ce3ec4c915
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.