Common use of Repayment of Identified Overpayments Clause in Contracts

Repayment of Identified Overpayments. UHealth 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 any applicable regulations and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If UHealth determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, UHealth shall repay that amount at the mean point estimate as calculated by the IRO. UHealth 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 UHealth to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that payor.

Repayment of Identified Overpayments. UHealth AAMC shall repay within 60 days any Overpayment(s) identified by the IRO in the either 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 UHealth AAMC determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, UHealth AAMC shall repay that amount at the mean point estimate as calculated by the IRO. UHealth AAMC 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 UHealth AAMC to the appropriate Medicare Medicare, state Medicaid, or state Medicaid TRICARE program contractor for appropriate follow up by that payor.

Repayment of Identified Overpayments. UHealth PPOA shall repay within 60 days any 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 UHealth PPOA determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, UHealth PPOA shall repay that amount at the mean point estimate as calculated by the IRO. UHealth PPOA shall make available to OIG all documentation that reflects the refund of any 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 UHealth PPOA to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that the payor.

Repayment of Identified Overpayments. UHealth SNAP shall repay within 60 days any 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 UHealth SNAP determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, UHealth SNAP shall repay that amount at the mean point estimate as calculated by the IRO. UHealth SNAP shall make available to OIG all documentation that reflects the refund of any 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 UHealth SNAP to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that the payor.

Repayment of Identified Overpayments. UHealth SMMC shall repay within 60 days any 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 UHealth SMMC determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, UHealth SMMC shall repay that amount at the mean point estimate as calculated by the IRO. UHealth SMMC shall make available to OIG all documentation that reflects the refund of any 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 UHealth SMMC to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that the payor.

Repayment of Identified Overpayments. UHealth Providence 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 any applicable regulations and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If UHealth Providence determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, UHealth Providence shall repay that amount at the mean point estimate as calculated by the IRO. UHealth Providence 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 UHealth Providence to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that payor.

Repayment of Identified Overpayments. UHealth TPRC shall repay within 60 days any 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 or Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If UHealth TPRC determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, UHealth TPRC shall repay that amount at the mean point estimate as calculated by the IRO. UHealth TPRC shall make available to OIG all documentation that reflects the refund of any 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 UHealth TPRC to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that the payor.

Repayment of Identified Overpayments. UHealth Agendia shall repay within 60 days any 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 UHealth Agendia determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, UHealth Agendia shall repay that amount at the mean point estimate as calculated by the IRO. UHealth Agendia shall make available to OIG all documentation that reflects the refund of any 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 UHealth Agendia to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that the payor.

Repayment of Identified Overpayments. UHealth CRC shall repay within 60 days any 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 UHealth CRC determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, UHealth CRC shall repay that amount at the mean point estimate as calculated by the IRO. UHealth CRC shall make available to OIG all documentation that reflects the refund of any 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 UHealth CRC to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that the payor.

Repayment of Identified Overpayments. UHealth Pentec shall repay within 60 days any 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 UHealth Pentec determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, UHealth Pentec shall repay that amount at the mean point estimate as calculated by the IRO. UHealth Pentec shall make available to OIG all documentation that reflects the refund of any 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 UHealth Pentec to the appropriate Medicare or applicable state Medicaid program contractor for appropriate follow up by that the payor.

Repayment of Identified Overpayments. UHealth Apria shall repay within 60 days any 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 UHealth Apria determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, UHealth Apria shall repay that amount at the mean point estimate as calculated by the IRO. UHealth Apria shall make available to OIG all documentation that reflects the refund of any 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 UHealth Apria to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that the payor.

Repayment of Identified Overpayments. UHealth THM shall repay within 60 days any the Overpayment(s) identified by the IRO in the Claims Review SampleSamples, 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 UHealth THM determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, UHealth THM shall repay that amount at the mean point estimate as calculated by the IRO. UHealth THM shall make available to OIG all documentation that reflects the refund of any the Overpayment(s) to the payor. OIG, in its sole discretion, may refer the findings of the Claims Review Sample Samples (and any related work papers) received from UHealth THM to the appropriate Medicare or state Medicaid program or Medicaid managed care program contractor for appropriate follow up by that the payor.

Repayment of Identified Overpayments. UHealth APS shall repay within 60 days any Overpayment(s) Overpayments identified by the IRO in the Quarterly 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 UHealth APS determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, UHealth APS shall repay that amount at the mean point estimate as calculated by the IRO. UHealth APS shall make available to OIG all documentation that reflects the refund of any 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 UHealth APS to the appropriate Medicare or state Medicaid program contractor or Medicare Managed Care or Medicaid Managed Care company for appropriate follow up by that payor.