Common use of Repayment of Identified Overpayments Clause in Contracts

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. §1320-7k(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 calculated by the IRO. Prime 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 workpapers) received from Prime to the appropriate Medicare contractor for appropriate follow up by that 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. §1320-7k(d§ 1320a-7k(d) and 42 C.F.R. §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 the any Overpayment(s) to the payor. OIG, in its sole discretion, may refer the findings of the Claims Review Sample (and any related workpaperswork papers) received from Prime to the appropriate Medicare program contractor for appropriate follow up by that payor.