News & Analysis as of

Overpayment Medicare Administrative Contractors (MAC)

Nelson Mullins Riley & Scarborough LLP

Understanding the Medicare Overpayment Appeals Process

Every Medicare provider should understand the Medicare administrative appeals process. Providers are entitled to be reimbursed for their services and want to keep those reimbursements safe from audits. However, if Medicare...more

Foley & Lardner LLP

Cardiac Medical Device Medicare Overpayment Self-Assessment – Methodology

Foley & Lardner LLP on

More than 900 hospitals across the United States are approaching a Centers for Medicare & Medicaid Services (CMS)-imposed deadline to report overpayments from the removal (explant) of defective cardiac medical devices if...more

Health Care Compliance Association (HCCA)

CMS offers correct billing tips for nonphysician outpatient services provided before or during inpatient stays

Compliance Today (March 2021) - The Centers for Medicare & Medicaid Services (CMS) has provided the following compliance notice: “In a recent report, the Office of Inspector General (OIG) determined that Medicare made...more

Health Care Compliance Association (HCCA)

Hospitals Were Overpaid $33M Over Device Credits; Policy May Change

Report on Medicare Compliance 29, no. 42 (November 23, 2020) - Medicare administrative contractors (MACs) will be coming to 911 hospitals for overpayments caused by unreported manufacturer credits for recalled or...more

Cozen O'Connor

Federal Court Enjoins Medicare Recoupment

Cozen O'Connor on

A Houston federal judge preliminarily enjoined the government from recouping alleged Medicare overpayments made to an ambulance service company facing bankruptcy. See Adams EMS, Inc. v. Azar, No. H-18-1443, 2018 BL 391263...more

Mintz - Health Care Viewpoints

Fifth Circuit Decision is Rare Victory Permitting District Court to Enjoin Recoupment Before Provider Exhausts Administrative...

The all-too-common story of a healthcare company declaring bankruptcy in the face of aggressive Medicare recoupment actions before the company even has a hearing before an Administrative Law Judge (ALJ) may get a new ending –...more

Robinson+Cole Health Law Diagnosis

Fifth Circuit Reinstates Provider’s Collateral Challenge to the Medicare Appeal Process

On March 27, 2018, the United States Court of Appeals for the Fifth Circuit held that a health care provider can seek an injunction in federal court against recoupment by Medicare of alleged overpayments despite not...more

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