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Index/Topics/Medicare Program Integrity Manual

Medicare Program Integrity Manual

The guidelines for targeting providers with high denial rates or atypical billing patterns.

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Jan 30, 2026

How have changes in program integrity funding historically affected the annual number and targeting of CDRs?

in federal health programs have historically expanded the scope and number of review activities—adding contractors and new postpayment and investigative tools—while persistent measurement and data-use...

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