{"component": "clause", "props": {"groups": [{"size": 11, "snippet": "The IRO shall randomly select and review a sample of 50 Paid Claims (Discovery Sample). The Paid Claims shall be reviewed based on the supporting documentation available at the Provider\u2019s office or under Provider\u2019s control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. If the Error Rate (as defined above) for the Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, the Provider should, as appropriate, further analyze any errors identified in the Discovery Sample. The Provider recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Sample or any other segment of the universe.)", "snippet_links": [{"key": "and-review", "type": "clause", "offset": [30, 40]}, {"key": "a-sample", "type": "definition", "offset": [41, 49]}, {"key": "paid-claims", "type": "definition", "offset": [56, 67]}, {"key": "based-on", "type": "clause", "offset": [122, 130]}, {"key": "supporting-documentation", "type": "definition", "offset": [135, 159]}, {"key": "available-at", "type": "definition", "offset": [160, 172]}, {"key": "the-provider", "type": "clause", "offset": [173, 185]}, {"key": "determine-whether", "type": "clause", "offset": [285, 302]}, {"key": "the-claim", "type": "definition", "offset": [303, 312]}, {"key": "error-rate", "type": "definition", "offset": [368, 378]}, {"key": "defined-above", "type": "clause", "offset": [383, 396]}, {"key": "no-additional", "type": "clause", "offset": [440, 453]}, {"key": "systems-review", "type": "definition", "offset": [487, 501]}, {"key": "the-guidelines", "type": "clause", "offset": [519, 533]}, {"key": "in-its-discretion", "type": "clause", "offset": [769, 786]}, {"key": "authorized-by", "type": "definition", "offset": [794, 807]}, {"key": "appropriate-authority", "type": "definition", "offset": [838, 859]}, {"key": "claims-included", "type": "clause", "offset": [892, 907]}], "samples": [{"hash": "hcBeeEyCTjl", "uri": "/contracts/hcBeeEyCTjl#discovery-sample", "label": "Corporate Integrity Agreement", "score": 21.0837475021, "published": true}, {"hash": "98WvTglQo2i", "uri": "/contracts/98WvTglQo2i#discovery-sample", "label": "Corporate Integrity Agreement", "score": 19.0862422998, "published": true}], "hash": "b5de5cbefef682038ad8d042a6a4e813", "id": 1}, {"size": 5, "snippet": "The IRO shall select and review a Discovery Sample of Medicare beneficiaries as described below in Sections 3 and 4. The medical records for the Medicare beneficiaries selected shall be reviewed based on the supporting documentation available at Good Shepherd\u2019s offices or under Good Shepherd\u2019s control and applicable billing and coding regulations and guidance to determine whether the beneficiary was eligible for the hospice benefit and whether all claims for hospice services furnished to the beneficiary were correctly coded, submitted, and reimbursed.", "snippet_links": [{"key": "and-review", "type": "clause", "offset": [21, 31]}, {"key": "medicare-beneficiaries", "type": "clause", "offset": [54, 76]}, {"key": "sections-3", "type": "clause", "offset": [99, 109]}, {"key": "medical-records", "type": "definition", "offset": [121, 136]}, {"key": "based-on", "type": "clause", "offset": [195, 203]}, {"key": "supporting-documentation", "type": "definition", "offset": [208, 232]}, {"key": "available-at", "type": "definition", "offset": [233, 245]}, {"key": "determine-whether", "type": "clause", "offset": [365, 382]}, {"key": "the-beneficiary", "type": "clause", "offset": [383, 398]}, {"key": "claims-for", "type": "clause", "offset": [452, 462]}, {"key": "services-furnished", "type": "clause", "offset": [471, 489]}], "samples": [{"hash": "l4E0Rnd1UAc", "uri": "/contracts/l4E0Rnd1UAc#discovery-sample", "label": "Corporate Integrity Agreement", "score": 24.1079279046, "published": true}, {"hash": "knr0vPWps9S", "uri": "/contracts/knr0vPWps9S#discovery-sample", "label": "Corporate Integrity Agreement", "score": 24.1079279046, "published": true}, {"hash": "hz17NXgpPPD", "uri": "/contracts/hz17NXgpPPD#discovery-sample", "label": "Corporate Integrity Agreement", "score": 24.1079279046, "published": true}], "hash": "080b48938fc3ca4996b9e24970a5392d", "id": 2}, {"size": 5, "snippet": "The IRO shall randomly select and review a sample of 50 Paid Claims (Discovery Sample). The Paid Claims shall be reviewed based on the supporting documentation available at RMC\u2019s office or under RMC\u2019s control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. Rural/Metro Corporation Corporate Integrity Agreement Appendix B If the Error Rate (as defined above) for the Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, RMC should, as appropriate, further analyze any errors identified in the Discovery Sample. RMC recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Sample or any other segment of the universe.)", "snippet_links": [{"key": "and-review", "type": "clause", "offset": [30, 40]}, {"key": "a-sample", "type": "definition", "offset": [41, 49]}, {"key": "paid-claims", "type": "definition", "offset": [56, 67]}, {"key": "based-on", "type": "clause", "offset": [122, 130]}, {"key": "supporting-documentation", "type": "definition", "offset": [135, 159]}, {"key": "available-at", "type": "definition", "offset": [160, 172]}, {"key": "determine-whether", "type": "clause", "offset": [271, 288]}, {"key": "the-claim", "type": "definition", "offset": [289, 298]}, {"key": "corporate-integrity-agreement", "type": "definition", "offset": [371, 400]}, {"key": "appendix-b", "type": "clause", "offset": [401, 411]}, {"key": "error-rate", "type": "definition", "offset": [419, 429]}, {"key": "defined-above", "type": "clause", "offset": [434, 447]}, {"key": "no-additional", "type": "clause", "offset": [491, 504]}, {"key": "systems-review", "type": "definition", "offset": [538, 552]}, {"key": "the-guidelines", "type": "clause", "offset": [570, 584]}, {"key": "in-its-discretion", "type": "clause", "offset": [802, 819]}, {"key": "authorized-by", "type": "definition", "offset": [827, 840]}, {"key": "appropriate-authority", "type": "definition", "offset": [871, 892]}, {"key": "claims-included", "type": "clause", "offset": [925, 940]}], "samples": [{"hash": "l71OHT6QMoq", "uri": "/contracts/l71OHT6QMoq#discovery-sample", "label": "Corporate Integrity Agreement", "score": 18.2443531828, "published": true}, {"hash": "g1irYkm9wuG", "uri": "/contracts/g1irYkm9wuG#discovery-sample", "label": "Corporate Integrity Agreement", "score": 18.2443531828, "published": true}], "hash": "82cd92f015c82a9d8b04dac521ed931b", "id": 3}, {"size": 4, "snippet": "The IRO shall randomly select and review a sample of 100 Paid Claims (Discovery Sample). The Paid Claims shall be reviewed based on: (i) the supporting documentation available at Rehab\u2019s office or under Rehab\u2019s control; (ii) appropriate contacts by the IRO with ordering physicians and Rehab customers and/or caregivers of Rehab customers; and (iii) applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. Among the issues to be reviewed are: (i) whether the power wheelchairs and accessories were correctly coded, submitted, billed to Federal health care programs appropriately; (ii) whether Rehab maintained in its records documentation of all supporting documentation described in 42 C.F.R. \u00a7 410.38(c); and (iii) whether Rehab\u2019s documentation mirrors the documentation the ordering physician\u2019s documentation. At least 25 claims in the Discovery Sample shall include a review of whether Rehab\u2019s documentation mirrors the documentation of the ordering physician. If the Error Rate (as defined above) for the Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, Rehab should, as appropriate, further analyze any errors identified in the Discovery Sample. Rehab recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Sample or any other segment of the universe.)", "snippet_links": [{"key": "and-review", "type": "clause", "offset": [30, 40]}, {"key": "a-sample", "type": "definition", "offset": [41, 49]}, {"key": "paid-claims", "type": "definition", "offset": [57, 68]}, {"key": "based-on", "type": "clause", "offset": [123, 131]}, {"key": "supporting-documentation", "type": "definition", "offset": [141, 165]}, {"key": "available-at", "type": "definition", "offset": [166, 178]}, {"key": "determine-whether", "type": "clause", "offset": [408, 425]}, {"key": "the-claim", "type": "definition", "offset": [426, 435]}, {"key": "the-issues", "type": "clause", "offset": [490, 500]}, {"key": "to-be-reviewed", "type": "clause", "offset": [501, 515]}, {"key": "federal-health-care-programs", "type": "definition", "offset": [614, 642]}, {"key": "review-of", "type": "clause", "offset": [950, 959]}, {"key": "error-rate", "type": "definition", "offset": [1050, 1060]}, {"key": "defined-above", "type": "clause", "offset": [1065, 1078]}, {"key": "no-additional", "type": "clause", "offset": [1122, 1135]}, {"key": "systems-review", "type": "definition", "offset": [1169, 1183]}, {"key": "the-guidelines", "type": "clause", "offset": [1201, 1215]}, {"key": "in-its-discretion", "type": "clause", "offset": [1437, 1454]}, {"key": "authorized-by", "type": "definition", "offset": [1462, 1475]}, {"key": "appropriate-authority", "type": "definition", "offset": [1506, 1527]}, {"key": "claims-included", "type": "clause", "offset": [1560, 1575]}], "samples": [{"hash": "fIbr7erkDFi", "uri": "/contracts/fIbr7erkDFi#discovery-sample", "label": "Corporate Integrity Agreement", "score": 19.6926762491, "published": true}, {"hash": "3ZR7rsErrVD", "uri": "/contracts/3ZR7rsErrVD#discovery-sample", "label": "Corporate Integrity Agreement", "score": 19.6926762491, "published": true}], "hash": "d25dd90a5021a3cb628e49cc9f8a445e", "id": 4}, {"size": 3, "snippet": "The IRO shall randomly select and review a sample of 100 Paid Claims (each constituting a \u201cDiscovery Sample\u201d) from the Population at each Covered Facility selected for review. The Paid Claims shall be reviewed based on the supporting documentation available at Dignity Health\u2019s office or under Dignity Health\u2019s control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. If the Error Rate (as defined above) for the Discovery Sample for any Covered Facility is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, Dignity Health shall, as appropriate, further analyze any errors identified in the Discovery Sample. Dignity Health recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Sample or any other segment of the universe.)", "snippet_links": [{"key": "and-review", "type": "clause", "offset": [30, 40]}, {"key": "a-sample", "type": "definition", "offset": [41, 49]}, {"key": "paid-claims", "type": "definition", "offset": [57, 68]}, {"key": "covered-facility", "type": "definition", "offset": [138, 154]}, {"key": "for-review", "type": "clause", "offset": [164, 174]}, {"key": "based-on", "type": "clause", "offset": [210, 218]}, {"key": "supporting-documentation", "type": "definition", "offset": [223, 247]}, {"key": "available-at", "type": "definition", "offset": [248, 260]}, {"key": "dignity-health", "type": "definition", "offset": [261, 275]}, {"key": "determine-whether", "type": "clause", "offset": [381, 398]}, {"key": "the-claim", "type": "definition", "offset": [399, 408]}, {"key": "error-rate", "type": "definition", "offset": [464, 474]}, {"key": "defined-above", "type": "clause", "offset": [479, 492]}, {"key": "no-additional", "type": "clause", "offset": [561, 574]}, {"key": "systems-review", "type": "definition", "offset": [608, 622]}, {"key": "the-guidelines", "type": "clause", "offset": [640, 654]}, {"key": "in-its-discretion", "type": "clause", "offset": [893, 910]}, {"key": "authorized-by", "type": "definition", "offset": [918, 931]}, {"key": "appropriate-authority", "type": "definition", "offset": [962, 983]}, {"key": "claims-included", "type": "clause", "offset": [1016, 1031]}], "samples": [{"hash": "l16c38c0flW", "uri": "/contracts/l16c38c0flW#discovery-sample", "label": "Corporate Integrity Agreement", "score": 21.4147843943, "published": true}, {"hash": "heLl9sajyqm", "uri": "/contracts/heLl9sajyqm#discovery-sample", "label": "Corporate Integrity Agreement", "score": 21.4147843943, "published": true}], "hash": "625b46d6b913b145b5e55a104775cc0d", "id": 5}, {"size": 2, "snippet": "The IRO shall randomly select and review a sample of a minimum of 50 Paid Claims, consisting of a minimum of 25 Group 2 claims and a minimum of 25 Group 3 claims. (Discovery Sample). The Paid Claims shall be reviewed based on the supporting documentation available at Hill-Rom\u2019s office or under Hill-Rom\u2019s control or, to the extent allowed by applicable Medicare coverage and documentation requirements, to which Hill-Rom has access and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. If the Error Rate (as defined above) for the Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, Hill-Rom should, as appropriate, further analyze any errors identified in the Discovery Sample. Hill-Rom recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Sample or any other segment of the universe.)", "snippet_links": [{"key": "and-review", "type": "clause", "offset": [30, 40]}, {"key": "a-sample", "type": "definition", "offset": [41, 49]}, {"key": "paid-claims", "type": "definition", "offset": [69, 80]}, {"key": "group-2", "type": "definition", "offset": [112, 119]}, {"key": "group-3", "type": "definition", "offset": [147, 154]}, {"key": "based-on", "type": "clause", "offset": [217, 225]}, {"key": "supporting-documentation", "type": "definition", "offset": [230, 254]}, {"key": "available-at", "type": "definition", "offset": [255, 267]}, {"key": "to-the-extent-allowed", "type": "clause", "offset": [318, 339]}, {"key": "medicare-coverage", "type": "clause", "offset": [354, 371]}, {"key": "documentation-requirements", "type": "clause", "offset": [376, 402]}, {"key": "determine-whether", "type": "clause", "offset": [495, 512]}, {"key": "the-claim", "type": "definition", "offset": [513, 522]}, {"key": "error-rate", "type": "definition", "offset": [578, 588]}, {"key": "defined-above", "type": "clause", "offset": [593, 606]}, {"key": "no-additional", "type": "clause", "offset": [650, 663]}, {"key": "systems-review", "type": "definition", "offset": [697, 711]}, {"key": "the-guidelines", "type": "clause", "offset": [729, 743]}, {"key": "in-its-discretion", "type": "clause", "offset": [971, 988]}, {"key": "authorized-by", "type": "definition", "offset": [996, 1009]}, {"key": "appropriate-authority", "type": "definition", "offset": [1040, 1061]}, {"key": "claims-included", "type": "clause", "offset": [1094, 1109]}], "samples": [{"hash": "irv0Z0IJOjZ", "uri": "/contracts/irv0Z0IJOjZ#discovery-sample", "label": "Corporate Integrity Agreement", "score": 20.7738141919, "published": true}, {"hash": "3g8RJL5kRaz", "uri": "/contracts/3g8RJL5kRaz#discovery-sample", "label": "Corporate Integrity Agreement (Hill-Rom Holdings, Inc.)", "score": 18.7385352498, "published": true}], "hash": "5b421169c86066bb744ec9d794267e6f", "id": 6}, {"size": 2, "snippet": "The Billing IRO shall randomly select and review a sample of 200 Paid Claims (Discovery Sample) each", "snippet_links": [{"key": "and-review", "type": "clause", "offset": [38, 48]}, {"key": "a-sample", "type": "definition", "offset": [49, 57]}, {"key": "paid-claims", "type": "definition", "offset": [65, 76]}], "samples": [{"hash": "8j469S1C9kR", "uri": "/contracts/8j469S1C9kR#discovery-sample", "label": "Corporate Integrity Agreement", "score": 30.2314191813, "published": true}, {"hash": "diWOyFBelFL", "uri": "/contracts/diWOyFBelFL#discovery-sample", "label": "Corporate Integrity Agreement", "score": 22.4271842103, "published": true}], "hash": "83e6928fc6c8a31706fc6c36d5d61915", "id": 7}, {"size": 2, "snippet": "The IRO shall randomly select and review a sample of 100 Paid Claims (Discovery Sample). The Paid Claims shall be reviewed based on the supporting documentation available at CareMed\u2019s office or under CareMed\u2019s control, (including but not limited to, an electronic or hard copy of the prescription, proof of delivery of the prescription, and any documentation relating to prior authorizations required by the payor for the prescription), applicable billing regulations and guidance, and Part D plan payment provisions to determine whether the claim was correctly submitted and reimbursed. For each Paid Claim reviewed, the IRO should verify that CareMed maintained documentation of (1) the prescription or order for the drug, item, or supply dispensed; (2) the delivery of the drug, item, or supply; and (3) any required preauthorization. If the Error Rate (as defined above) for the Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, CareMed should, as appropriate, further analyze any errors identified in the Discovery Sample. CareMed recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Sample or any other segment of the universe.)", "snippet_links": [{"key": "and-review", "type": "clause", "offset": [30, 40]}, {"key": "a-sample", "type": "definition", "offset": [41, 49]}, {"key": "paid-claims", "type": "definition", "offset": [57, 68]}, {"key": "based-on", "type": "clause", "offset": [123, 131]}, {"key": "supporting-documentation", "type": "definition", "offset": [136, 160]}, {"key": "available-at", "type": "definition", "offset": [161, 173]}, {"key": "not-limited", "type": "clause", "offset": [234, 245]}, {"key": "an-electronic", "type": "clause", "offset": [250, 263]}, {"key": "hard-copy", "type": "clause", "offset": [267, 276]}, {"key": "delivery-of-the", "type": "clause", "offset": [307, 322]}, {"key": "relating-to", "type": "definition", "offset": [359, 370]}, {"key": "required-by", "type": "definition", "offset": [392, 403]}, {"key": "payment-provisions", "type": "clause", "offset": [498, 516]}, {"key": "determine-whether", "type": "clause", "offset": [520, 537]}, {"key": "the-claim", "type": "definition", "offset": [538, 547]}, {"key": "the-delivery", "type": "clause", "offset": [756, 768]}, {"key": "required-preauthorization", "type": "clause", "offset": [811, 836]}, {"key": "error-rate", "type": "definition", "offset": [845, 855]}, {"key": "defined-above", "type": "clause", "offset": [860, 873]}, {"key": "no-additional", "type": "clause", "offset": [917, 930]}, {"key": "systems-review", "type": "definition", "offset": [964, 978]}, {"key": "the-guidelines", "type": "clause", "offset": [996, 1010]}, {"key": "in-its-discretion", "type": "clause", "offset": [1236, 1253]}, {"key": "authorized-by", "type": "definition", "offset": [1261, 1274]}, {"key": "appropriate-authority", "type": "definition", "offset": [1305, 1326]}, {"key": "claims-included", "type": "clause", "offset": [1359, 1374]}], "samples": [{"hash": "e22QDolNY6j", "uri": "/contracts/e22QDolNY6j#discovery-sample", "label": "Corporate Integrity Agreement (PharMerica CORP)", "score": 24.3538672142, "published": true}, {"hash": "hg6GAuMK6zf", "uri": "/contracts/hg6GAuMK6zf#discovery-sample", "label": "Corporate Integrity Agreement", "score": 19.4613278576, "published": true}], "hash": "4fefdd543f1faac825a34cfe0b636ad1", "id": 8}, {"size": 2, "snippet": "The IRO shall randomly select and review a sample of 10 Beneficiary Paid Claims from each of the Clinics in the Sampling Frame. All the Paid Claims shall be reviewed based on the supporting documentation available at Gambro\u2019s office or under Gambro\u2019s control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed.\ni. If the Error Rate (as defined in Appendix D) for the Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, Gambro should, as appropriate, further analyze any errors identified in the Discovery Sample. Gambro recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Sample or any other segment of the universe.)\nii. If the Discovery Sample indicates that the Error Rate is 5% or greater, the IRO shall perform a Full Sample and a Systems Review, as described below.", "snippet_links": [{"key": "and-review", "type": "clause", "offset": [30, 40]}, {"key": "a-sample", "type": "definition", "offset": [41, 49]}, {"key": "paid-claims", "type": "definition", "offset": [68, 79]}, {"key": "sampling-frame", "type": "clause", "offset": [112, 126]}, {"key": "based-on", "type": "clause", "offset": [166, 174]}, {"key": "supporting-documentation", "type": "definition", "offset": [179, 203]}, {"key": "available-at", "type": "definition", "offset": [204, 216]}, {"key": "determine-whether", "type": "clause", "offset": [321, 338]}, {"key": "the-claim", "type": "definition", "offset": [339, 348]}, {"key": "error-rate", "type": "definition", "offset": [407, 417]}, {"key": "appendix-d", "type": "definition", "offset": [433, 443]}, {"key": "no-additional", "type": "clause", "offset": [487, 500]}, {"key": "systems-review", "type": "definition", "offset": [534, 548]}, {"key": "the-guidelines", "type": "clause", "offset": [566, 580]}, {"key": "in-its-discretion", "type": "clause", "offset": [804, 821]}, {"key": "authorized-by", "type": "definition", "offset": [829, 842]}, {"key": "appropriate-authority", "type": "definition", "offset": [873, 894]}, {"key": "claims-included", "type": "clause", "offset": [927, 942]}, {"key": "full-sample", "type": "clause", "offset": [1129, 1140]}], "samples": [{"hash": "iBKz9o2iZ0M", "uri": "/contracts/iBKz9o2iZ0M#discovery-sample", "label": "Corporate Integrity Agreement", "score": 29.340862423, "published": true}, {"hash": "bPZiyXyn3Ir", "uri": "/contracts/bPZiyXyn3Ir#discovery-sample", "label": "Corporate Integrity Agreement (Davita Inc)", "score": 19.0, "published": true}], "hash": "a42ca926deb83352365e2946f07d088f", "id": 9}, {"size": 2, "snippet": "The IRO shall randomly select and review a sample of 100 Paid Claims for services rendered by CCH of New York (Discovery Sample). The Paid Claims shall be randomly selected in proportion to the total volume of Paid Claims in the Population accounted for by each of CCH of New York\u2019s branch offices. The Paid Claims shall be reviewed based on the supporting documentation available at CCH\u2019s office(s) or under CCH\u2019s control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. If the Error Rate (as defined above) for the Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, CCH should, as appropriate, further analyze any errors identified in the Discovery Sample. CCH recognizes that OIG or another HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Sample or any other segment of the universe.)", "snippet_links": [{"key": "and-review", "type": "clause", "offset": [30, 40]}, {"key": "a-sample", "type": "definition", "offset": [41, 49]}, {"key": "services-rendered", "type": "definition", "offset": [73, 90]}, {"key": "of-new-york", "type": "definition", "offset": [98, 109]}, {"key": "randomly-selected", "type": "definition", "offset": [155, 172]}, {"key": "total-volume", "type": "definition", "offset": [194, 206]}, {"key": "branch-offices", "type": "definition", "offset": [283, 297]}, {"key": "based-on", "type": "clause", "offset": [333, 341]}, {"key": "supporting-documentation", "type": "definition", "offset": [346, 370]}, {"key": "available-at", "type": "definition", "offset": [371, 383]}, {"key": "determine-whether", "type": "clause", "offset": [485, 502]}, {"key": "the-claim", "type": "definition", "offset": [503, 512]}, {"key": "error-rate", "type": "definition", "offset": [568, 578]}, {"key": "defined-above", "type": "clause", "offset": [583, 596]}, {"key": "no-additional", "type": "clause", "offset": [640, 653]}, {"key": "systems-review", "type": "definition", "offset": [687, 701]}, {"key": "the-guidelines", "type": "clause", "offset": [719, 733]}, {"key": "in-its-discretion", "type": "clause", "offset": [953, 970]}, {"key": "authorized-by", "type": "definition", "offset": [978, 991]}, {"key": "appropriate-authority", "type": "definition", "offset": [1022, 1043]}, {"key": "claims-included", "type": "clause", "offset": [1076, 1091]}], "samples": [{"hash": "gq3uh71bFYU", "uri": "/contracts/gq3uh71bFYU#discovery-sample", "label": "Corporate Integrity Agreement (Amedisys Inc)", "score": 29.1327857632, "published": true}, {"hash": "7FHxe5ePRgM", "uri": "/contracts/7FHxe5ePRgM#discovery-sample", "label": "Corporate Integrity Agreement", "score": 21.5667351129, "published": true}], "hash": "fff22f99384ed1b8663ce009cf764ebd", "id": 10}], "next_curs": "ClkSU2oVc35sYXdpbnNpZGVyY29udHJhY3RzcjULEhZDbGF1c2VTbmlwcGV0R3JvdXBfdjU2IhlkaXNjb3Zlcnktc2FtcGxlIzAwMDAwMDBhDKIBAmVuGAAgAA==", "clause": {"parents": [["claims-review", "Claims Review"], ["iro-removal-termination", "Iro Removal Termination"], ["oig-removal-of-iro", "OIG Removal of IRO"], ["effective-and-binding-agreement", "EFFECTIVE AND BINDING AGREEMENT"], ["corporate-integrity-obligations", "CORPORATE INTEGRITY OBLIGATIONS"]], "title": "Discovery Sample", "size": 66, "children": [["results-of-discovery-sample", "Results of Discovery Sample"], ["discovery-sample-1", "Discovery Sample 1"]], "id": "discovery-sample", "related": [["product-testing", "Product Testing", "Product Testing"], ["random-drug-testing", "Random Drug Testing", "Random Drug Testing"], ["api", "API", "API"], ["re-weighing-product", "RE-WEIGHING PRODUCT", "RE-WEIGHING PRODUCT"], ["shop-drawings-product-data-and-samples", "SHOP DRAWINGS, PRODUCT DATA AND SAMPLES", "SHOP DRAWINGS, PRODUCT DATA AND SAMPLES"]], "related_snippets": [], "updated": "2025-07-07T12:37:39+00:00", "also_ask": [], "drafting_tip": "", "explanation": "The Discovery Sample clause defines the process by which a subset of documents or data is selected and reviewed during the discovery phase of litigation or investigation. Typically, this clause outlines the criteria for choosing the sample, such as random selection or targeting specific categories, and may specify the sample size and review procedures. Its core practical function is to streamline the discovery process by allowing parties to assess the relevance and scope of potentially responsive materials without having to review the entire dataset, thereby saving time and resources while ensuring fairness."}, "json": true, "cursor": ""}}