Please study the hot linked rule referenced below for our Medicare program discussions; thank you. Consider, please, whether a typical relatively inexperience-in-practice physician in a small group or a solo medical practice will or should be able to read, understand, and apply what you are going to read. Consider also whether there should be anything included in health reform legislation addressing concerns that providers, and their patients, and each and all of us as well, might have regarding what you will read and how the procedures therein described enhance or derogate from good health care delivery.
quote
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Part 405
[CMS-6025-F]
RIN 0938-AN42
Medicare Program; Limitation on Recoupment of Provider and
Supplier Overpayments
AGENCY: Centers for Medicare & Medicaid Services (CMS),
HHS.
ACTION: Final rule.
SUMMARY: This final rule implements a provision of the
Medicare Prescription Drug, Improvement, and Modernization
Act of 2003 (MMA) which prohibits recouping Medicare
overpayments from a provider or supplier that seeks a
reconsideration from a Qualified Independent Contractor
(QIC). This provision changes how interest is to be paid to
a provider or supplier whose overpayment is reversed at
subsequent administrative or judicial levels of appeal.
This final rule defines the overpayments to which the
limitation applies, how the limitation works in concert with
the appeals process, and the change in our obligation to pay
interest to a provider or supplier whose appeal is
successful at levels above the QIC.
quote
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Part 405
[CMS-6025-F]
RIN 0938-AN42
Medicare Program; Limitation on Recoupment of Provider and
Supplier Overpayments
AGENCY: Centers for Medicare & Medicaid Services (CMS),
HHS.
ACTION: Final rule.
SUMMARY: This final rule implements a provision of the
Medicare Prescription Drug, Improvement, and Modernization
Act of 2003 (MMA) which prohibits recouping Medicare
overpayments from a provider or supplier that seeks a
reconsideration from a Qualified Independent Contractor
(QIC). This provision changes how interest is to be paid to
a provider or supplier whose overpayment is reversed at
subsequent administrative or judicial levels of appeal.
This final rule defines the overpayments to which the
limitation applies, how the limitation works in concert with
the appeals process, and the change in our obligation to pay
interest to a provider or supplier whose appeal is
successful at levels above the QIC.
