On Monday, in an opinion issued by Judge James Boasberg, the U.S. District Court for the District of Columbia ordered the Department of Health and Human Services (HHS) to clear its backlog of Medicare reimbursement appeals by the end of 2020. Judge Boasberg’s opinion granted a motion for summary judgment filed by the American Hospital Association in American Hospital Association v. Burwell (14-851). Continue reading
On March 29, 2013 the Florida Department of Financial Services issued a “Notice to Medical Providers” regarding the liquidation of Universal Health Care, Inc. (UHC) and Universal Health Care Insurance Company, Inc. (UHCIC). The Notice was sent to providers whose records indicated they “may have provided medical services” to members/policyholders of UHC and UHCIC. Fotheringill & Wade currently represents several Maryland facilities in the UHCIC bankruptcy and, through our advocacy and court filings we are currently expected to recover almost $500k for our Maryland clients involved in the Receivership.
If you have any denied claims for UHCIC it may not be too late to get paid for those claims. Although the Proofs of Claim filing deadline was in 2014, we believe that we can file late claims for a limited period of time, until approximately November 30, 2016. If you have any claims denied by UHCIC with service dates between 02/01/2012 and 03/31/2013, we would be happy to pursue them on your behalf. Our prior experience in representing other Maryland facilities positions us to successfully represent providers’ interests in this matter.
The Receiver has announced that Class 2 medical providers (i.e. those for whom Proofs of Claim were filed by the 6/30/14 deadline) will be paid in full at 100% of the claim pricing, and will be paid prior to any remaining class of creditor. Providers with late filed claims will be Class 8 creditors (not Class 2 priority). However, based on the published financial statements of the Receivership, it is expected that Class 8 creditors will also be paid in full at 100% of claims pricing. Our other clients are expected to receive large payments on aged claims that were written off years ago. We hope you will take advantage of this opportunity. We can pursue any denied or underpaid UHCIC claims dating from 02/01/2012 through 03/31/2013, and medical providers are expected to be paid in full at 100% of the of claim pricing.
Today, the Centers for Medicare and Medicaid Services (CMS) posted the highly-anticipated details of the 2016 Hospital Appeals Settlement. Beginning December 1, 2016, CMS will make available an administrative settlement process for inpatient status claims. This process will be open to eligible hospitals willing to withdraw certain pending appeals in exchange for timely partial payment (66% of the net allowable amount). CMS is encouraging hospitals with inpatient status claims currently in the appeals process at the Administrative Law Judge (ALJ) level or the Departmental Appeals Board level to consider utilizing the proposed settlement process. To request participation in the process, hospitals must complete an Expression of Interest and submit it to MedicareAppealsSettlement@cms.hhs.gov. The deadline for hospitals to submit their Expression of Interest is January 31, 2017. Continue reading
On Monday, October 31st, the Centers for Medicare & Medicaid Services (CMS) announced that they had awarded the long-awaited new round of contracts for the Medicare Fee-for-Service Recovery Audit Contractors (RACs). The agency identified the awarding of contracts to the following:
- Region 1 – Performant Recovery, Inc.
- Region 2 – Cotiviti, LLC
- Region 3 – Cotiviti, LLC
- Region 4 – HMS Federal Solutions
- Region 5 – Performant Recovery, Inc.
On September 28, 2016 the Centers for Medicare and Medicaid Services (CMS) announced that it will “once again allow eligible providers to settle their inpatient status claims currently under appeal using the Hospital Appeals Settlement process.” At the time of the announcement no details on the new settlement offer were provided. Today, CMS announced that they will host a 2016 Hospital Appeals Settlement Call on November 16, 2016, from 1:30 to 3:00 P.M. Continue reading