Part B Insider (Multispecialty) Coding Alert

Published on Thu Jan 10, 2013 PDF

Medicare payments for illegal immigrants are under the microscope, as the OIG identified certain "overpayments" for beneficiaries who were unlawfully present in the United States for a period of time, reports Palmetto GBA. This glitch could occur when the Social Security Administration is slow to update its records of beneficiaries’ residential status, and thus the Medicare files are late in updating.

CMS is now requiring Medicare Administrative Contractors to collect any 2009 paid claims where the beneficiary was illegally present in the United States at the time the provider rendered services. If your MAC finds such overpayments, you can appeal the claim denial by requesting a redetermination via the normal appeals process.