Very clear & concise the obligations of the provider re: repayments of overpayments or audit findings. More important to identify process improvements to eliminate overpayments & audit recoveries.
Originally posted on Prince Lobel Blog:
Effective September 3, 2013, the Centers for Medicare and Medicaid Services (CMS) revised provisions of the Medicare Financial Management Manual that relate to provider requests for Extended Repayment Schedules (ERS) in connection with Medicare overpayments, including overpayments identified by Recovery Audit Contractors (RACs).
In general, if a Medicare Administrative Contractor or provider determines that an overpayment exists, the provider is required to repay that overpayment within 30 days.
Chapter 4 of the Medicare Financial Management Manual provides a process for a provider to request an ERS (formerly known as an Extended Repayment Plan), if repayment within 30 days would constitute a “hardship.” A hardship is defined to exist “when the total amount of all outstanding overpayments (principal and interest) not included in an approved, existing repayment schedule is ten percent or greater than the total Medicare payments made for the cost reporting period covered by the most recently submitted cost report, or for the previous calendar year for a non-cost report provider.”