Medicare Part B Newsline March 2012 - Cahaba GBA

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Change Request (CR) 7681 establishes a new process that allows for ADI providers and/or suppliers tobypass ADI information collection on the appropriate CMS 855 form or in the internet-based PECOS webapplication. CR7681 instructs that Medicare contractors will:Not require documentation from the ADI provider/supplier for proof of their accreditation; andNot require providers/suppliers to complete the ADI section in the internet-based PECOS applicationnor in the appropriate CMS-855 form.Instead, Medicare and its contractors will receive this information directly from the accreditingorganizations.Additional InformationThe official instruction, CR7681, issued to your carriers and A/B MACs regarding this change may beviewed at http://www.cms.gov/Transmittals/downloads/R407PI.pdf on the CMS website.MLN Matters® MM7681Medicare B Newsline March 2012 54
Immediate Recoupment for Fee for Service Claims OverpaymentsNote: This article was revised on February 10, 2012, to reflect the revised CR7688 issued on February 9,2012. In the article, the CR release date, transmittal number, and the Web address for accessing CR7688were revised. All other information is the same.Provider Types AffectedThis MLN Matters® article is intended for all Part A, and all Part B Providers, Physicians, and Supplierswho bill Medicare contractors (carriers, Fiscal Intermediaries (FIs), Regional Home Health Intermediaries(RHHIs), Medicare Administrative Contractors (A/B MACs) Durable Medical Equipment (DME MACs),)for services to Medicare beneficiaries.Provider Action NeededChange Request (CR) 7688 is policy that implements a standard “immediate recoupment” process that givesproviders the option to avoid interest from accruing on claims overpayments when the debt is recouped infull prior to or by the 30th day from the initial demand letter date. See the ‘Key Points’ section of this articlefor specifics.BackgroundCurrently, Medicare contractors begin recoupment of an overpayment on Day 41 from the date of the initialdemand letter. Interest accrues and assesses on an overpayment if not paid in full by day 30.Key PointsThe “immediate recoupment” process implemented in CR7688 allows providers to request that recoupmentbegin prior to day 41. Providers who elect this option may avoid paying interest if the overpayment isrecouped in full prior to day 31.Key to understanding this change is that providers who request an immediate recoupment must realize it isconsidered a voluntary repayment1. Providers who choose immediate recoupment must do so in writing to the contractors. . Also, notethe following:2. The request may be for:a one-time request for a specific demanded overpayment (the total amount of the demandedoverpayment); ora permanent request for the specific demanded overpayment and all future overpayments.3. The request may be submitted via regular mail, facsimile, or e-mail and the request must include theProvider’s name, contact phone number, Medicare number and/or National Provider Identifier (NPI),Provider or Chief Financial Officer's signature, demand letter number and what option the provideris requesting.4. By choosing immediate recoupment, providers must understand that they are waiving their rights tointerest under Section 935 of the Medicare Modernization Act (MMA) should the overpayment bereversed at the Administration Law Judge level (ALJ) or subsequent higher levels.Medicare B Newsline March 2012 55
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Medicare Part B Newsline March 2012 - Cahaba GBA

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