Home Health & Hospice Week

It’s time to keep track of more outlier payments. A HHH Medicare Administrator Con-tractor is reprocessing claims affected by erroneous recoupments for outlier payments. MAC CGS began reprocessing such claims June 24, it says on its website.

Background: The Medicare claims system ran the quarterly reconciliation process on April 30 and did not reconcile the outliers properly, resulting in $10 million in erroneous overpayment determinations. Claims adjustments were triggered based on the incorrect total amounts, recouping outlier payments that were not actually over the cap.

MACs returned the erroneous takebacks in late May. Now they are reprocessing claims with the appropriate outlier amount, CGS explains.