CMS adds targeted probe and educate to the Medicare program integrity manual

by Home Health Line.

CMS has issued a change request to add a targeted probe and educate sub-section to the Medicare program integrity manual.

The information will be added to the third chapter, which deals with verifying potential errors and taking corrective actions, according to change request 10876. The change takes effect Sept. 17, 2018.

The guidance for Medicare Administrative Contractors (MACs) includes an overview of the program, provider selection, one-on-one provider education, post-probe activity and referrals.

CMS and MACs implemented the targeted probe and educate program nationwide on Oct 1, 2017. Two probe and educate pilots came before it.

Related link: View the associated transmittal at https://go.cms.gov/2wxAhFo. View the change request at and change request at https://go.cms.gov/2Pgfm1k.