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Overpayments: Create culture of compliance

Q. What is the best remedy for overpayment problems?

A. In previous columns, I discussed how the 60-day overpayment rule presents a myriad of problems and questions that are sometimes difficult for an HME supplier to identify and address.

CGS changes offset request process


NASHVILLE, Tenn. – CGS Administrators, the Jurisdiction B MAC, will no longer accept offset requests at the time of claim re-openings and adjustments, it said in a July 25 bulletin. Starting Aug.

Overpayments: Follow protocol

Q. How do I return an overpayment to the government?

A. Typically, suppliers report and return overpayments to the DME MAC of jurisdiction. Each DME MAC has a standard overpayment refund form. The supplier simply provides information and submits a refund check.

Overpayments: Extrapolate overpayments

Q. How deeply do I need to investigate potential problems?

A. My last column explained CMS’s final rule clarifying the 60-day rule, which allows a supplier up to six months to quantify an overpayment once it’s identified.

Overpayments: Exercise reasonable diligence

Q. What do I need to know about the 60-day rule?

A. The Affordable Care Act requires a person who has received an overpayment to report and return the overpayment to the government.  

GAO pokes holes in CMS’s MA audit program


WASHINGTON – The Government Accountability Office isn’t pleased with CMS’s progress in recovering substantial amounts of improper payments from Medicare Advantage organizations.

Providers must report overpayments going back six years


WASHINGTON – CMS has revised the look-back period for overpayments from 10 to six years, according to a final rule issued Feb. 11.

Overpayments for diabetes supplies persist, OIG says


INDIANAPOLIS – The Office of Inspector General is not satisfied with National Government Services’ progress in preventing overpayments for diabetic test strips.

PMD claims without G code are suspect, OIG says


WASHINGTON – The Office of Inspector General (OIG) calls into question claims for power mobility devices (PMDs) without corresponding G-code claims in a new report.

In brief: Stakeholders keep eye on doc fix, CMS issues refunds


WASHINGTON – As this year’s congressional session winds down, HME stakeholders are eyeing the “doc-fix” bill as the best vehicle for H.R. 1717.