Repayment of Identified Overpayments. Progenity shall repay within 60 days the Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations or Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity shall repay that amount at the mean point estimate as calculated by the IRO. Progenity shall make available to OIG all documentation that reflects the refund of the Overpayment(s) to the payor. OIG, in its sole discretion, may refer the findings of the Claims Review Sample (and any related work papers) received from Progenity to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the payor.
Repayment of Identified Overpayments. Extendicare shall repay within 30 days any Overpayment(s) identified in the Discovery Samples, regardless of the Error Rate, and (if applicable) the Full Sample(s), including the IRO’s estimate of the actual Overpayment in the Population as determined in accordance with Section A.3 above, in accordance with payor refund policies. Extendicare shall make available to OIG all documentation that reflects the refund of the Overpayment(s) to the payor.
Repayment of Identified Overpayments. PPOA shall repay within 60 days the Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If PPOA determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, PPOA shall repay that amount at the mean point estimate as calculated by the IRO. PPOA shall make available to OIG all documentation that reflects the refund of the Overpayment(s) to the payor. OIG, in its sole discretion, may refer the findings of the Claims Review Sample (and any related work papers) received from PPOA to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the payor.
Repayment of Identified Overpayments. Xx. Xxxxxx shall repay within 60 days any Overpayments identified by the IRO in the Quarterly Claims Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Xx. Xxxxxx determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Xx. Xxxxxx shall repay that amount at the mean point estimate as calculated by the IRO. Xx. Xxxxxx shall make available to OIG all documentation that reflects the refund of the Overpayment(s) to the payor. OIG, in its sole discretion, may refer the findings of the Quarterly Claims Review Sample (and any related work papers) received from Xx. Xxxxxx to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that payor.
Repayment of Identified Overpayments. Xxx shall repay within 60 days any Overpayment(s) identified in each Quarterly Claims Sample and Dialysis Access Procedures Sample (including any extrapolated amounts identified in accordance with Section A.3 of this Appendix), regardless of the Error Rate, to the appropriate payor and in accordance with payor refund policies. Xxx shall make available to OIG all documentation that reflects the refund of the Overpayment(s) to the payor.
Repayment of Identified Overpayments. LabTox shall repay within 60 days any Overpayments identified by the IRO in the Quarterly Claims Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If LabTox determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, LabTox shall repay that amount at the mean point estimate as calculated by the IRO. LabTox shall make available to OIG all documentation that reflects the refund of the Overpayment(s) to the payor. OIG, in its sole discretion, may refer the findings of the Quarterly Claims Review Sample (and any related work papers) received from LabTox to the appropriate Medicare, state Medicaid, or Medicaid Managed Care program contractor for appropriate follow up by that payor.
Repayment of Identified Overpayments. Good Shepherd shall repay within 30 days any Overpayment(s) identified in the Discovery Sample, regardless of the Error Rate, and (if applicable) the Full Sample, including the IRO’s estimate of the actual Overpayment in the Population as determined in accordance with Section A.5 above, in accordance with payor refund policies. Good Shepherd shall make available to OIG all documentation that reflects the refund of the Overpayment(s) to the payor.
Repayment of Identified Overpayments. Genova shall repay within 60 days the Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Genova determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Genova shall repay that amount at the mean point estimate as calculated by the IRO. Genova shall make available to OIG all documentation that reflects the refund of the Overpayment(s) to the payor. OIG, in its sole discretion, may refer the findings of the Claims Review Sample (and any related work papers) received from Genova to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the payor.
Repayment of Identified Overpayments. CHSI shall repay within 60 days the Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations or Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If CHSI determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, CHSI shall repay that amount at the mean point estimate as calculated by the IRO. CHSI shall make available to OIG all documentation that reflects the refund of the Overpayment(s) to the payor. OIG, in its sole discretion, may refer the findings of the Claims Review Sample (and any related work papers) received from CHSI to the appropriate Medicare program contractor for appropriate follow up by the payor.
Repayment of Identified Overpayments. Prime shall repay within 60 days any Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and 42 C.F.R § 401.301-305 (and any applicable CMS guidance) (the “CMS overpayment rule”). If Prime determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Prime shall repay that amount at the mean point estimate as calculated by the IRO. Prime shall make available to OIG all documentation that reflects the refund of any Overpayment(s) to the payor. OIG, in its sole discretion, may refer the findings of the Claims Review Sample (and any related work papers) received from Prime to the appropriate Medicare program contractor for appropriate follow up by that payor.
