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Pub. 100-08 Medicare Program Integrity

Guidance to clarify (due to contractor misinterpretation) the role of the Conditions of Participation (COP) requirements in determining when care is reasonable and necessary.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: January 30, 2004

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.