Incarcerated Beneficiaries

News & Analysis as of

CMS Issues Refunds For Collections Made On Incorrectly Identified Incarcerated Beneficiary Overpayments

Medicare does not cover supplies or services for persons who are incarcerated at the time the services are rendered. However, Medicare had purportedly paid providers in error for many such claims and sought to recover those...more

A Review of CMS' Approach to $125 Million Recoupment of Payments to Providers for Services to Incarcerated / Unlawfully Present...

CMS seeks to recover from providers $125 million in alleged overpayments for services to beneficiaries who are belatedly identified as ineligible (incarcerated/unlawfully present). In this post, Sheppard Mullin examines the...more

CMS Demands Repayment for Items and Services Furnished to Incarcerated Beneficiaries

CMS recently initiated recoveries from providers and suppliers for services furnished to beneficiaries while “incarcerated,” which generally are not covered by Medicare. Such services are not covered because a state or local...more

Expect Increased Medicare Denials for Incarcerated Beneficiaries and Unlawful Aliens

The Department of Health and Human Services’ Office of Inspector General (OIG) recently published two reports finding Medicare improperly paid providers millions of dollars for incarcerated beneficiaries and unlawful aliens...more

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