decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Program_Memos / 2000 / AB-00-116
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Article Overview
This article explains Medicare guidance for contractors developing Local Medical Review Policies (LMRPs). It matters because it standardizes how policies are formatted, submitted, and documented, which affects policy development and internal compliance workflows. The content is aimed at Medicare contractors, policy writers, and operational staff responsible for creating or revising LMRPs, and it covers general requirements for policy templates, dates, content fields, and publication-related expectations.
Why This Topic Matters
The memo establishes a required structure for LMRPs and specifies how policy information should be organized and delivered. It is relevant to teams responsible for drafting, reviewing, and maintaining Medicare medical review policies.
Article Sections
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New LMRP Format Requirements
Introduces the requirement to use a standard policy format for newly developed policies. The section focuses on general formatting expectations and implementation timing.
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New Time Frame and Email Address Requirement
Describes submission timing and routing expectations for final policies. It addresses communication channels and distribution to regional contacts.
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New HyperTextMarkup Language (HTML) Requirement
Explains the move to HTML for new policies and identifies presentation-related requirements for electronic policy files. It also references an example format resource.
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Exhibit - Local Medical Review Policy Format
Provides the required LMRP template structure and the list of standard fields included in the policy exhibit. The section covers administrative, geographic, coding, documentation, and revision-related components.
What You Will Learn
- The required structure and formatting expectations for LMRPs
- Timing and routing requirements for submitting final policy materials
- General HTML presentation expectations for policy documents
- The standard fields included in the LMRP template
- What administrative, geographic, coding, documentation, and revision information belongs in an LMRP
Who Should Read This
- Medicare contractors
- Medical policy developers
- Coding and reimbursement staff
- Compliance and audit personnel
- Healthcare administrative staff
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