Part B Insider (Multispecialty) Coding Alert

Physician Notes:

Look for Adjustments to Extended Repayment

Plus: Pennsylvania physician breaks bad.

Don’t be surprised to see changes if you need to request an Extended Repayment Schedule. Changes to the ERS process took effect Sept. 3, Part B MAC Palmetto GBA notes on its website.

For example: While your MAC or CMS evaluates your ERS request, Medicare now will recoup 30 percent on the overpayment for which the request was submitted. That’s down from 100 percent, Palmetto points out. “The 30 percent recoupment will be applied to the outstanding overpayment in addition to the required monthly payment submissions by the provider while the plan is under review,” the MAC explains.

However, you should continue to submit monthly payments in accordance with your proposed repayment schedule until you receive written approval/denial. If you don’t submit your scheduled payment, “recoupment procedures will begin at a 100 percent rate,” the MAC continues.

 

See other ERS changes, including adjustments to the hardship definition, at www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/fin106c04.pdf.