Eli's Hospice Insider

Published on Wed Sep 15, 2021 PDF

Thanks to a federal watchdog agency, one HHH Medicare Administrative Contractor is now collecting more hospice per-beneficiary cap-related overpayments.

When it examined cap year 2017, the HHS Office of Inspector found that Palmetto GBA “accurately calculated cap amounts but did not collect all cap overpayments or pay refunds associated with lookback years due to two internal policies,” says a new OIG report on the topic.

Cost: “Palmetto did not collect lookback overpayments totaling $545,639 or send refunds to hospices totaling $17,513,” the OIG says.

The OIG urges Palmetto to collect the identified overpayments, change its policies so it will no longer waive certain lookback overpayments, and improve communications between its relevant departments.

Palmetto agrees with all three recommendations. For example, as of April 2021, “all overpayments and refunds are issued to the provider regardless of the computed amount,” Palmetto tells the OIG in a comment letter on the report. Formerly such overpayments and refunds had to exceed a certain threshold. The 16-page report is at www.oig.hhs.gov/oas/reports/region6/61908003.pdf.