42 CFR 421.120 : Public Health (Part 1 To Parts 1009-1099) — (§ 414.1 To Parts 427-429) — Centers For Medicare & Medicaid Services, Department Of Health And Human Services (Continued) (§ 414.1 To Parts 427-429) — Medicare Program (Continued) (§ 414.1 To Parts 427-429) — Medicare Contracting (§ 421.1 To Subpart F) — Intermediaries (§ 421.100 To § 421.128) — Performance criteria.

(a) Application of performance criteria. As part of the intermediary evaluations authorized by section 1816(f) of the Act, CMS periodically assesses the performance of intermediaries in their Medicare operations using performance criteria. The criteria measure and evaluate intermediary performance of functional responsibilities such as -

(1) Correct coverage and payment determinations;

(2) Responsiveness to beneficiary concerns; and

(3) Proper management of administrative funds.

(b) Basis for criteria. CMS will base the performance criteria on -

(1) Nationwide intermediary experience;

(2) Changes in intermediary operations due to fiscal constraints; and

(3) HFCA's objectives in achieving better performance.

(c) Publication of criteria. The development and revision of criteria for evaluating intermediary performance is a continuing process. Therefore, before the beginning of each evaluation period, CMS will publish the performance criteria as a notice in the Federal Register.