Home Health & Hospice Week

Accidental Medicare overpayments to your agency are not just yours to keep. So reminds one Home Health & Hospice Medicare Administrative Contractor.

“As you know, providers may at times receive incorrect payment (e.g., for services/items not covered, erroneously billed, etc.),” MAC CGS explains in a recent article on voluntary refunds. “When this happens, a refund should be sent to the contractor. Otherwise, an overpayment, which is a debt due to the Medicare program, will be established when the error is identified,” CGS says.

“Medicare expects providers to exercise care when billing and accepting payment, and also expects that providers will promptly bring incorrect payments to the MAC’s attention,” CGS chides in the article. “These submissions acknowledge your awareness of this expectation and confirm a measure of compliance.”

But even if you do return overpayments, CMS and the MACs may still come after you. “Please be aware that the CMS Online Manual, Publication 100-08, Chapter 4, Section 4.2.2.8.1.3 states: ‘The acceptance of a voluntary refund in no way affects or limits the rights of the Federal Government or any of its agencies or agents to pursue any appropriate criminal, civil, or administrative remedies arising from or relating to these or any other claims,’” CGS emphasizes at https://cgsmedicare.com/articles/cope27516.pdf.