CMS View of IMR

Recently, it has been reported that an IMR (Independent Medical Review) was taken into consideration by CMS within the California jurisdiction. This information is true for all jurisdictions. Depending on the age of the IMR, CMS will ask if the decision has been appealed and they will look to see if the treatment has changed based on the IMR. If the IMR is the latest document – there are no medical records dated after the IMR date – CMS will accept the IMR directions. NuQuest/Bridge Pointe has taken this into consideration for all cases in which an IMR is the most recent medical document.

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