MES Certification Navigator
PI6

CMS-Required Outcome

CMS-required outcome

System can recover improper payments by: (a) Tracking repayments and outstanding amounts due at an individual transaction level as well as aggregating by provider, time period (b) Supporting electronic transfer back to the state (c ) Temporarily limiting future payments to provider(s) who have an outstanding recovery balance.

Default metrics
  • Total recovered dollars/Total dollars identified
Regulatory sources
  • None cited

Other Program Integrity outcomes