Overcoming Medicare Overpayments With Extended Repayment Schedules

October 10, 2013

mmcs1998:

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…

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Healthcare Improvements

December 21, 2012

So nice to see so many changes being considered in healthcare.  Most importantly is to keep the focus on the patient and doing what is best for him/her.  There are so many processes that need improvement which will reduce expenses and costs.  The fear of reimbursement reduction will dissipate when reviewing costs and eliminating waste offsets it.  Let’s work together to do what is best for the patient and the provider will benefit.


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