© 2021 Palmetto GBA, LLC
We frequently update our articles to reflect the latest changes and updates to Medicare, and strongly recommend you visit this article at link below to confirm you have the latest version.
Published Date:01/04/2021
Printed Date: 9/22/2015
URL: http://palmgba.com/marlowe/redesign6/article.html
Over the past few months, CMS and Palmetto GBA contacted Medicare Advantage (MA) Plans not wishing to make voluntary direct payments to the Medicare FFS program about the possibility of waiving their claims filing deadlines and/or otherwise giving payment consideration to MA overpayment claims. This would enable affected providers to rebill their claims to the MAs. More than 100 MA plans (XLSX, 17 KB) agreed to participate on a voluntary basis.
Since not all MA overpayments are included in the TFW process, each provider should carefully review its claims listing (attached to its letter) to identify which of its erroneous MA overpayments need to be (1) repaid to Medicare Fee For Service (FFS), and (2) pursued through the corresponding MA plans’ Point of Contact (POC).
On December 6, 2019, the TFW demand letters will be issued to affected providers. In addition to identifying FFS claims requiring repayment, these letters will identify participating MA plans and their designated POCs. Each TFW letter will include the following:
Current data on the total number of MAOs, participating MA Plans, and FFS claims that will be affected by the TFW process is indicated below:
Number of MAOs: 40 Number of MA Plans: 108 Number of Affected FFS Claims: 14,816 Additional information is available in articles entitled “Medicare Advantage (MA) Plan Overpayments: Background” and “Medicare Advantage (MA) Plan Overpayments - Frequently Asked Questions (FAQs).” Questions may be addressed to MA.Response@palmettogba.com.
We value your opinion and want to provide the highest-quality and most relevant Medicare knowledge possible. Please let us know if this article was helpful.
It didn't answer my question This article was helpful
We’re glad we could help you today and appreciate your feedback. When you rate our articles as most helpful, we know that we are on the right track for providing you with important news and information.
We're sorry this article didn't help you today. We'll use your feedback to review this article to try to revise or expand it. Contact us with more feedback or a question on this topic.
Last Updated: 01/04/2021