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Medicare Program Integrity Manual. Downloads. Chapter 1 - Overview of Medical Review (MR) and Benefit Integrity (BI) Chapter 4 - Program Integrity (PDF). Medicare Program Integrity Manual. Chapter 6 - Medicare Contractor Medical Review. Guidelines for Specific Services. Table of Contents. (Rev. 808, 07-13-18).Medicare Program Integrity Manual Chapter 4 - Program Integrity Table of Contents Rev 944 Issued: 03-06-20 Transmittals for Chapter 4 41 - Introduction 411 Prepayment MR of claims always results in an "initial determination." See Pub. 100-04, chapter 29, section 30.3, for a complete definition of "initial Reference the Medicare Program Integrity Manual 100-08), Chapter 3, Section 3.3.2.4. 4. For more information on Medicare signature requirements, CMS Manual System, Pub. 100-08, Medicare Program Integrity Manual, Chapter 4, §4.2. Unified Program Integrity Contractors (UPICs) are responsible for