E.3 - Assumptions Amendment 1.docx
Posted: April 15, 2026
• Type: .docx
• Size: 0.04MB
Opportunity Assistant
Loading
Overview
Related Opportunity
Related Agency
Summary
This amendment to the Statement of Work (SOW) details workload projections for the PPI MEDIC program over a 12-month period, encompassing both the Base and Option Years.
The amendment outlines specific assumptions regarding workload variances, which may fluctuate by +/- 10% based on factors such as the timing of audits and the volume of medical records submitted for review.
It provides a comprehensive breakdown of anticipated activities, including various types of audits (self-audits, PI audits, national audits), recurring and discrete reports, internal reports, meetings, presentations, and additional tasks related to PPI MEDIC operations.
Key workload projections include:
- A total of 22 ad hoc audits for Part C
- 16 ad hoc audits for Part D within the specified period.
The amendment also specifies the number of recurring reports required:
- 10 quarterly releases for Part C
- 18 quarterly releases for Part D.
Meetings are scheduled biweekly or monthly with various stakeholders, including CMS and user groups.
Additionally, it outlines expectations for presentations at conferences and training sessions related to fraud waste and abuse.
Other activities include data analysis projects, correspondence handling (with significant volumes projected), and responses to congressional inquiries and FOIA requests.
The document emphasizes that many OIG recommendations will be integrated into ongoing audits and reports while noting that appeal reconsiderations will not commence until January 1, 2027.
The amendment outlines specific assumptions regarding workload variances, which may fluctuate by +/- 10% based on factors such as the timing of audits and the volume of medical records submitted for review.
It provides a comprehensive breakdown of anticipated activities, including various types of audits (self-audits, PI audits, national audits), recurring and discrete reports, internal reports, meetings, presentations, and additional tasks related to PPI MEDIC operations.
Key workload projections include:
- A total of 22 ad hoc audits for Part C
- 16 ad hoc audits for Part D within the specified period.
The amendment also specifies the number of recurring reports required:
- 10 quarterly releases for Part C
- 18 quarterly releases for Part D.
Meetings are scheduled biweekly or monthly with various stakeholders, including CMS and user groups.
Additionally, it outlines expectations for presentations at conferences and training sessions related to fraud waste and abuse.
Other activities include data analysis projects, correspondence handling (with significant volumes projected), and responses to congressional inquiries and FOIA requests.
The document emphasizes that many OIG recommendations will be integrated into ongoing audits and reports while noting that appeal reconsiderations will not commence until January 1, 2027.
Show All