The deadline for 911 hospitals to self-report overpayments tied to cardiac medical device replacement procedures is quickly approaching, according to the National Law Review.
In November 2020, the HHS' Office of Inspector General estimated that nearly half of the 6,558 claims it audited for cardiac medical device replacement procedures from Jan. 1, 2015, to June 30, 2017, didn't comply with all Medicare billing requirements. Specifically, the audit looked at if hospitals across the U.S. correctly reported manufacturer credits for defective cardiac devices. The audit estimated that noncompliance with the billing requirement likely resulted in $33 million in overpayments to 911 hospitals.
CMS issued letters to the hospitals in the audit in late 2020 and early 2021 and gave them 240 days to investigate, identify, report and return the device-related overpayments from the last six years. Hospitals are expected to report their findings to their Medicare administrative contractors. CMS asked hospitals to provide a description of the methodology used to calculate the overpayments from the last six years and a sample size of claims reviewed in the self-assessment. Additionally, if the hospitals want to challenge the rebate-reporting requirement or believe they handled the manufacturer credits appropriately, they are encouraged to document that it didn't have an overpayment.
The deadline for some of the hospitals is as early as Aug. 28, according to the report.
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