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Successful Appeal – Medicare Overpayment Reduced by Over 3.3 Million

Recently, a Medicare certified home health agency received a letter from CMS alleging that the home health agency received an overpayment in the amount of $3,351,149.00. Rivas Goldstein, LLP prepared a Redetermination appeal that contested the overpayment by arguing that the extrapolation methods utilized by CMS were not conducted in accordance with Medicare guidelines and argued that the services rendered were medically necessary and met Medicare guidelines. As a result of the Request for Redetermination submitted by Rivas Goldstein, the amount of the overpayment was reduced from $3,351,149.00 to $55,538.52.

If your business receives a letter from CMS alleging that it owes a substantial overpayment, you have rights and the allegations contained in these letters can often be successfully challenged. Rivas Goldstein, LLP can help.