Program Integrity Screening definition

Program Integrity Screening means a review of an individual’s or entity’s program integrity history, which may include a review of the individual’s or entity’s history of exclusion or other sanctions imposed with respect to participation in Medicare, Medicaid, or CHIP; history of failure to pay Medicare debts in a timely manner; current or prior law enforcement investigations or administrative actions; affiliations with individuals or entities that have a history of program integrity issues; and other information pertaining to the trustworthiness of the individual or entity.

Program Integrity Screening means a review of an individual’s or entity’s program integrity history and current status, which may include a review of the individual’s or entity’s eligibility,

Program Integrity Screening means a review of an individual’s or entity’s program integrity history, which may include a review of Medicare or Medicaid, or any combination of the two, program exclusions or other sanctions, current or prior law enforcement investigations or administrative actions, affiliations with individuals or entities that have a history of program integrity issues, or other information pertaining to the trustworthiness of the individual or entity.

Examples of Program Integrity Screening in a sentence

• CMS shall conduct a Program Integrity Screening for each individual and entity on the Proposed Revised Participant Provider List and the Proposed Revised Preferred Provider List.

• Any such requests shall be made in accordance with the procedures set forth in section 5.2, except that CMS need not conduct a Program Integrity Screening in the case of a request to make a late addition to the certified Care Partner List or a request to increase the number of CRP Tracks in which a Care Partner or Downstream Care Partner is participating.

• After reviewing the Program Integrity Screening results, CMS shall submit to the Hospital, by the deadlines specified in the CRP Calendar, an approved Care Partner List identifying the individuals and entities that CMS has approved to be Care Partners and Downstream Care Partners for the Performance Period.

• Congress has the power to enact this legis- lation pursuant to the following: Article 1, Section 8 of the U.S. Constitu- tion By Ms. BROWNLEY: H.R. 9126.

• CMS states that it conducted a Program Integrity Screening for each individual or entity the DCE proposed to add to its Proposed DC Participant Provider List and Proposed Preferred Provider List and reserved the right to reject any individual or entity proposed for inclusion on the basis of the criteria described in Section 4.02.E.

• Medicare Program Integrity: Screening Out Errors, Fraud, and Abuse (Congressional testimony), June 25, 2014.

• CMS shall conduct a Program Integrity Screening for each individual and entity on the Proposed Revised DC Participant Provider List and the Proposed Revised Preferred Provider List.

• After review of such notice, CMS reserves the right to conduct a Program Integrity Screening with respect to such Participating Practitioner, Downstream Episode Initiator, NPRA Sharing Partner, NPRA Sharing Group Practice Practitioner, or BPCI Advanced Entity and may remove such Participating Practitioner, Downstream Episode Initiator, NPRA Sharing Partner, NPRA Sharing Group Practice Practitioner, or BPCI Advanced Entity from the Participant Profile, QPP List, or Financial Arrangement List, as applicable.

• The successful Bidders’ proposal must include a plan to safeguard the confidentiality of the Bank's business information, legacy applications and data.

• CMS may also conduct a Program Integrity Screening on the Participant and any NPRA Sharing Partner, NPRA Sharing Group Practice Practitioner, and BPCI Advanced Entity previously identified on the Financial Arrangement List.