CMS Releases New Rules Limiting Recoupment Pending Claims Appeals

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Providers, physicians, and suppliers of medical goods and services (collectively, "providers") may now be able to avoid recoupment of alleged overpayments pending appeals, but at a cost. Providers who ultimately lose their appeals will be charged an exorbitant interest rate (currently 11.375%) on any outstanding overpayments not recouped by CMS pending the appeals. Providers who do not wish to risk paying interest on unsuccessful appeals must voluntarily remit overpayments to CMS within thirty days of receiving a demand notice from the Medicare contractor. CMS established the revised procedures for recoupment of overpayments pursuant to Section 935 of the Medicare Prescription Drug, Improvement and Modernization act of 2003.

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