With the onslaught of the new Patient Protection and Affordable Care Act (PPACA) provisions making it a false claim to retain known overpayments and the new CMS guidance on the newly-reinstated Voluntary Self-Referral Disclosure Protocol (SRDP), Wisconsin Physician Services (WPS)–the Medicare Part B Contractor for Illinois, Michigan, Wisconsin, and Minnesota–released its revised overpayment notification and voluntary refund forms. The forms are divided into Medicare Financial/Medicare Secondary Payer (MSP) and non-MSP. MSP forms are to be used when Medicare paid as the primary payor, but the records show that Medicare should have been the secondary payor due to Workers’ Compensation, VA, Disability, etc.
The Overpayment Notification forms (MSP/non-MSP) and the Refund forms (MSP/non-MSP) are each one-page forms. The Overpayment Notification forms are not used for sending in voluntary refunds; rather, they are merely notifications to WPS of overpayments and a request by the provider for the contractor to issue a formal demand letter to the provider for the overpayment amount. Once the overpayments have been processed and created and the provider has received the demand letter, the provider will have 30 days to refund the money without accruing interest. There are three methods in which a provider may refund the overpayment:
1. Withholding Payment – The provider has the option of having the overpayments withheld from future Medicare payments so long as the overpayment is more than $10. This option would be indicated on the Overpayment Notification form.
2. Immediate Offset – Providers have the option of filling out an Immediate Offset Request form to have the overpayments offset. WPS emphasizes that the offset does not eliminate interest payments when the accounts receivable is not offset in full within 30 days.
3. Issuing a Check – Providers that do not want payment withheld or their overpayments offset, they may send in a check to WPS for the overpayment.
For those providers that do not seek a formal demand letter prior to initiating a refund, they may submit the Refund form (MSP/non-MSP) with the check in accordance with the instructions set forth in the form.
For more information on the CMS SRDP, please visit the CMS SRDP page as well as our September 24, 2010 entry on the process of self disclosure. Please note: submitting an Overpayment Notification form or a Refund form does not constitute voluntary disclosure as provided in the SRDP.
For more information, please contact Abby Pendleton, Esq. at (248) 996-8510 or (212) 734-0128 or visit the HLP website.