US · guidance
CMS Pub. 100-09, ch. 6, § 30.9
PRRS Operations
MACs shall maintain PRRS operations as a collaborative effort between the PCC and POE units. This
partnership ensures providers receive consistent, accurate, and timely information regarding complex
inquiries that can’t be answered by the MAC’s telephone or written inquiries or staff that require
significant research. MACs shall design and staff the PRRS component to efficiently address more
complex provider questions including those related to coverage policy, coding and payment policy. This
structure allows for adequate research time to answer complex inquiries in a timely and efficient
manner.
PRRS staff shall also identify potential provider education topics based on complex inquiries received.
When the MAC determines that general provider education on specific topics would be beneficial to the
provider community and help to reduce inquiries, these topics shall be developed into educational
resources.
The PRRS shall also handle complex beneficiary inquiries that can’t be resolved by CCO.
History
(Rev. 13683; Issued: 04-08-26; Effective: 05-08-26; Implementation: 05-08-26)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
90be596d78aeb3d4e1a0864dc9344fc4e31801e5af40fcb1f52b47f1756fcc40
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