Common use of Repayment of Identified Overpayments Clause in Contracts

Repayment of Identified Overpayments. Provider 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 Provider determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Provider shall repay that amount at the mean point estimate as calculated by the IRO. Provider 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 Provider to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that payor.

Repayment of Identified Overpayments. Provider APS 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 Provider APS determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Provider APS shall repay that amount at the mean point estimate as calculated by the IRO. Provider APS 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 Provider 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.

Repayment of Identified Overpayments. Provider MPG 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 Provider MPG determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Provider MPG shall repay that amount at the mean point estimate as calculated by the IRO. Provider MPG 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 Provider MPG to the appropriate Medicare or Medicare, state Medicaid program program, or TRICARE contractor for appropriate follow up by that payor.

Repayment of Identified Overpayments. Provider LFAC 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 Provider LFAC determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Provider LFAC shall repay that amount at the mean point estimate as calculated by the IRO. Provider LFAC 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 Provider LFAC to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that payor.

Repayment of Identified Overpayments. Provider EPIPG 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 Provider EPIPG determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Provider EPIPG shall repay that amount at the mean point estimate as calculated by the IRO. Provider EPIPG 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 Provider EPIPG to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that payor.

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

Repayment of Identified Overpayments. Provider Practitioner 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 Provider Practitioner determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Provider Practitioner shall repay that amount at the mean point estimate as calculated by the IRO. Provider Practitioner 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 Provider Practitioner to the appropriate Medicare or state Medicaid program contractor or managed care organization for appropriate follow up by that payor.

Repayment of Identified Overpayments. Provider SPI 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 Provider SPI determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Provider SPI shall repay that amount at the mean point estimate as calculated by the IRO. Provider SPI 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 Provider SPI to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by that payor.