July 01, 2019

CMS Revises Guidance Regarding the Use of Statistical Sampling for Overpayment Estimation

Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., The Health Law Partners, P.C., Farmington Hills, MI

Introduction

On September 28, 2018, the Centers for Medicare & Medicaid Services (CMS) announced updates to its sub-regulatory guidance related to Medicare contractors’ use of statistical sampling for estimating overpayments.  The updates, effective January 2, 2019, were announced via Change Request 10067, Transmittal 828, and served to revise the Medicare Program Integrity Manual (MPIM) (CMS Internet-Only Manual 100-08) Chapter 8, Section 8.4.1  

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