Implement Fraud Prevention Predictive Modeling Prepayment Edits
Guidance for the CR that implements the requirements developed under CR 7669, Transmittal 1049, and to make the changes to the CWF and shared systems that will allow the Fraud Prevention System (FPS) to review claims approved for payment by CWF and to make a payment determination that is returned to the shared systems for appropriate action with as minimal impact on the current claims flow as possible.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 11, 2012
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