Medicare Compliance & Reimbursement

Industry Notes:

Know These MAC Facts on Accelerated Payment Recoupment

If you intend to submit a debt dispute over COVID-19 Accelerated and Advance Payment (CAAP) recoupment, one Medicare Administrative Contractor (MAC) has some fresh guidance to review.

Details: On Aug. 11, Part B MAC Palmetto GBA updated its CAAP guidance with a reminder about debt disputes and how the Centers for Medicare & Medicaid Services (CMS) was dealing with payment recoupment.

“In March of 2021, CMS began recouping outstanding CAAP balances, one year from the date on which a provider or supplier received their CAAP,” notes Palmetto. “Starting late August 2022, any outstanding CAAP balances shall start the demand process to recover the debt(s). Once demanded, the CAAP Debt Dispute (CDD) process grants you an opportunity to dispute the accuracy of the amount listed in the demand letter,” the Part B MAC cautions.

After Medicare providers receive their demand letter, they have 15 days to submit a CDD via email or by mail carrier. If you choose to send your CDD by mail, it must be postmarked by the 15th day, Palmetto says. However, “submitting the CDD request will not stop the recoupment process,” cautions the MAC.

Resource: Check out Palmetto’s announcement at www.palmettogba.com/palmetto/jjb.nsf/DIDC/H11WLEQ3FE~Emergency and Disaster Instructions.