Waltham, Mass.-based Alere, a medical diagnostics products company, continues to fight a CMS decision to revoke its subsidiary's Medicare billing privileges.
On Oct. 12, the subsidiary, Arriva Medical, received a notice that CMS was revoking Arriva's Medicare supplier billing number and banning it from re-enrolling in the Medicare program for three years, effective Nov. 4, according to Alere. CMS alleged Arriva Medical submitted claims for 211 deceased patients over the course of five years.
However, Alere believes the Medicare claims in question were submitted in response to valid refill orders from Medicare beneficiaries or their caregivers and said Arriva has not received or retained improper reimbursement for these claims.
Now Arriva, which provides diabetes testing supplies to Medicare beneficiaries, said it has filed an appeal with the CMS administrative law judge seeking to reinstate Arriva's billing status. Arriva expects the judge to hear the appeal within 30 days and issue a decision within three months.
"We believe the recent action by CMS to remove Arriva from CMS billing is unlawful, arbitrary and capricious, and harmful to the more than 500,000 patients who depend on Arriva for these critical supplies," Arriva said in a news release. "We are confident that Arriva is in compliance with CMS guidelines and look forward to an expeditious and favorable outcome for both Arriva and the hundreds of thousands of patients who depend on us. The number of purported instances cited by CMS is de minimis relative to the nearly 5.8 million total claims filed by Arriva during that same period."
Additionally, Alere announced Wednesday that Arriva has filed a complaint in the U.S. District Court for the District of Columbia. The complaint seeks to compel CMS to stay the process regarding the competitive bidding contract termination while the CMS appeal is ongoing and to provisionally reinstate Arriva's billing number while the company pursues the appeal. Arriva said it expects a decision on its motions to enjoin on or about Jan. 5.
In the complaint, Arriva alleges that CMS' decision to bar Arriva from participating in Medicare is driven by a desire to reduce its longstanding backlog of administrative claim-reimbursement appeals, according to the release.
A CMS representative said the agency had no comment on this case.
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