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Medicare overpayments represent a significant legal and financial issue for healthcare providers. The Centers for Medicare & Medicaid Services (CMS) have set forth specific guidelines to address these occurrences. The issue will arise either when a facility...
Imagine receiving a notice that could significantly impact the financial health of your private practice. That is the reality for physicians when faced with a Medicare overpayment notice. This is not just a request for repayment; it is a complex issue with legal...
Medicare overpayment issues can have significant financial and legal implications for healthcare providers. Unfortunately, such claims are not uncommon and may be on the rise. A recent study predicts that Medicare overpayments may increase by 20% in 2023, translating...
In their efforts to live up to their continuing promises to reduce the deficit, Washington, DC lawmakers are focusing on Medicare Advantage. Specifically, they are investigating billions of dollars that were purportedly generated by overdiagnoses targeting older...
If the federal government believes that they sent a wrongful Medicare payment, they will expect the business to return the funds. This generally begins with an Initial Demand Letter. This first communication from the United States Centers for Medicare and Medicaid...
Physicians throughout the country are finding themselves the recipients of a mailing from the government claiming that they must pay back Medicare payouts related to birth tissue injections. Part of the reason the demand is so frustrating is that it appears the...
Allegations of a Medicare overpayment are not uncommon. The government estimates that it overpays millions in Medicare claims to physicians and healthcare providers every single year. The government states these overpayments are of the result of a place-of-service...
The Department of Health and Human Services (HHS) recently announced that it is digging into risk adjustment tactics it claims may have led to overpayments. The review will focus specifically on certain Medicare Advantage (MA) plans. Secretary Xavier Becerra noted the...
When the Centers for Medicare and Medicaid Services (CMS) identifies an overpayment, it views the overpayment as a debt owed by the practice or health care organization to the federal government. These alleged overpayments can happen for any number of reasons,...
The United States Department of Medicare and Medicaid Services (CMS) uses a number of different resources to aid in the completion of its many operations. This includes contracts with different entities to help determine if the CMS made overpayments to health care...