Medicare/Medicaid--Five Years to Recoup Overpayments

The U.S. Centers for Medicare & Medicaid Services (CMS) will now have up to five years to recoup Medicare overpayments resulting from coding mistakes or other claims errors, according to the AOA Advocacy Group. A 2012 report found the previous three-year recoupment limit prevented the CMS from collecting more than $300 million dollars annually. Read more.

CMS Prepayment Reviews More Common with ECPs

The rapid expansion of a U.S. Centers for Medicare & Medicaid Services (CMS) initiative, launched last year to crack down on improper billing and claim errors, has meant more optometrists across the nation are receiving Medicare prepayment review notices, according to the AOA Third Party Center Executive Committee. The new prepayment review program means health care practitioners, including optometrists, will have to more diligently avoid common claim filing errors – such as coding mistakes or missing signatures – if they wish to ensure prompt payment, according to AOA Third Party Center Executive Committee members. Read more.

Shared Saving Program from Medicare Launched

The U.S. Centers for Medicare & Medicaid Services (CMS) recently launched the Shared Saving Program and will release the names of participating accountable care organizations (ACOs) soon. The program will return a portion of savings to an authorized ACO so long as the individuals and entities delivering care for the ACO meet designated quality-of-care standards. A second program reporting period will begin July , and CMS should announce participating ACOs within the next seven weeks. Read more.