Common use of Repayment of Identified Overpayments Clause in Contracts

Repayment of Identified Overpayments. Progenity shall repay within 60 days the Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations or Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity shall repay that amount at the mean point estimate as calculated by the IRO. Progenity 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 work papers) received from Progenity to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the payor.

Repayment of Identified Overpayments. Progenity Practitioner shall repay within 60 days the Overpayment(s) any Overpayments 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 or and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity Practitioner determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Practitioner shall repay that amount at the mean point estimate as calculated by the IRO. Progenity 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 Progenity Practitioner to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the that payor.

Repayment of Identified Overpayments. Progenity Subject Facilities shall repay within 60 days the any Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations or and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”), or TRICARE guidance. If Progenity UHS determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Subject Facilities shall repay that amount at the mean point estimate as calculated by the IRO. Progenity UHS 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 work papers) received from Progenity UHS to the appropriate Medicare Medicare, state Medicaid, or state Medicaid TRICARE program contractor for appropriate follow up by the that payor.

Repayment of Identified Overpayments. Progenity Healogics shall repay within 60 days the Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and 42 C.F.R. § 401.301- 305 (and any applicable regulations or Centers for Medicare and Medicaid Services (CMSCMS guidance) guidance (the “CMS overpayment rule”). If Progenity Healogics determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Healogics shall repay that amount at the mean point estimate as calculated by the IRO. Progenity Healogics 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 work papers) received from Progenity Healogics to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the payor.payor.‌

Repayment of Identified Overpayments. Progenity Align shall repay within 60 days the Overpayment(s) any Overpayments 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 or and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity Align determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Align shall repay that amount at the mean point estimate as calculated by the IRO. Progenity Align 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 Progenity Align to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the that payor.

Repayment of Identified Overpayments. Progenity Gamma shall repay within 60 days the Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and 42 C.F.R. § 401.301-305 (and any applicable regulations or Centers for Medicare and Medicaid Services (CMSCMS guidance) guidance (the “CMS overpayment rule”). If Progenity Gamma determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Gamma shall repay that amount at the mean point estimate as calculated by the IRO. Progenity Gamma 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 work papers) received from Progenity Gamma to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the payor.

Repayment of Identified Overpayments. Progenity Radeas shall repay within 60 days the Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations or Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity Radeas determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Radeas shall repay that amount at the mean point estimate as calculated by the IRO. Progenity Radeas 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 work papers) received from Progenity Radeas to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the payor.

Repayment of Identified Overpayments. Progenity The Practice shall repay within 60 days the Overpayment(s) any Overpayments 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 or and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity the Practice determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity the Practice shall repay that amount at the mean point estimate as calculated by the IRO. Progenity The Practice 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 Progenity the Practice to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the that payor.

Repayment of Identified Overpayments. Progenity OC and Xxxxxx shall repay within 60 days the Overpayment(s) any Overpayments 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 or and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity determines OC and Xxxxxx determine that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity OC and Xxxxxx shall repay that amount at the mean point estimate as calculated by the IRO. Progenity OC and Xxxxxx 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 Progenity OC and Xxxxxx to the appropriate Medicare or and state Medicaid program contractor for appropriate follow up by the that payor.

Repayment of Identified Overpayments. Progenity Medstar shall repay within 60 days the Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and 42 C.F.R. § 401.301-305 (and any applicable regulations or Centers for Medicare and Medicaid Services (CMSCMS guidance) guidance (the “CMS overpayment rule”). If Progenity Medstar determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Medstar shall repay that amount at the mean point estimate as calculated by the IRO. Progenity Medstar 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 Corporate Integrity Agreement - Medstar Claims Review Sample (and any related work papers) received from Progenity Medstar to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the payor.

Repayment of Identified Overpayments. Progenity Xxxx Clinic shall repay within 60 days the Overpayment(s) any Overpayments 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 or and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity Xxxx Clinic determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Xxxx Clinic shall repay that amount at the mean point estimate as calculated by the IRO. Progenity Xxxx Clinic 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 Progenity Xxxx Clinic to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the that payor.

Repayment of Identified Overpayments. Progenity Xxxxxxx shall repay within 60 days the any Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations or and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity Xxxxxxx determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Xxxxxxx shall repay that amount at the mean point estimate as calculated by the IRO. Progenity Xxxxxxx 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 work papers) received from Progenity Xxxxxxx to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the that payor.

Repayment of Identified Overpayments. Progenity Xxxxxxxxx shall repay within 60 days the any Overpayment(s) identified by the IRO in the either Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations or and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity Millcreek determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Xxxxxxxxx shall repay that amount at the mean point estimate as calculated by the IRO. Progenity Millcreek 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 work papers) received from Progenity Millcreek to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the that payor.

Repayment of Identified Overpayments. Progenity THM shall repay within 60 days the Overpayment(s) identified by the IRO in the Claims Review SampleSamples, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations or and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity THM determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity THM shall repay that amount at the mean point estimate as calculated by the IRO. Progenity THM 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 Samples (and any related work papers) received from Progenity THM to the appropriate Medicare or state Medicaid program or Medicaid managed care program contractor for appropriate follow up by the payor.

Repayment of Identified Overpayments. Progenity The Covered Entities shall repay within 60 days the Overpayment(s) any Overpayments 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 or and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity determines the Covered Entities determine that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity the Covered Entities shall repay that amount at the mean point estimate as calculated by the IRO. Progenity The Covered Entities 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 Progenity the Covered Entities to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the payor.that payor.‌

Repayment of Identified Overpayments. Progenity Xxxxxxx shall repay within 60 days the Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations or and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity Xxxxxxx determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Xxxxxxx shall repay that amount at the mean point estimate as calculated by the IRO. Progenity Xxxxxxx 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 work papers) received from Progenity Xxxxxxx to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the payor.

Repayment of Identified Overpayments. Progenity Xxxxxxx shall repay within 60 days the any Overpayment(s) identified by the Claims Review IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations or and Centers for Medicare and & Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity Xxxxxxx determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Xxxxxxx shall repay that amount at the mean point estimate as calculated by the Claims Review IRO. Progenity Xxxxxxx 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 work papers) received from Progenity Xxxxxxx to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the that payor.

Repayment of Identified Overpayments. Progenity Xxxxxx shall repay within 60 days the Overpayment(s) any Overpayments identified by the IRO in the Claims Review Quarterly Drug Inventory Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and 42 C.F.R. §§ 401.301- 305 (and any applicable regulations or Centers for Medicare and Medicaid Services (CMSCMS guidance) guidance (the “CMS overpayment rule”). If Progenity Xxxxxx determines that the CMS overpayment rule requires that an extrapolated Overpayment be be‌ repaid, Progenity Xxxxxx shall repay that amount at the mean point estimate as calculated by the IRO. Progenity Xxxxxx 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 Progenity Xxxxxx to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the payor.that payor.‌

Repayment of Identified Overpayments. Progenity Practitioner shall repay within 60 days the Overpayment(s) any Overpayments 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 or and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity Practitioner determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Practitioner shall repay that amount at the mean point estimate as calculated by the IRO. Progenity 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 Progenity Practitioner to the appropriate Medicare or state Medicaid program contractor or managed care organization for appropriate follow up by the that payor.

Repayment of Identified Overpayments. Progenity Agendia shall repay within 60 days the Overpayment(s) identified by the IRO in the Claims Review Sample, in accordance with the requirements of 42 U.S.C. § 1320a-7k(d) and any applicable regulations or and Centers for Medicare and Medicaid Services (CMS) guidance (the “CMS overpayment rule”). If Progenity Agendia determines that the CMS overpayment rule requires that an extrapolated Overpayment be repaid, Progenity Agendia shall repay that amount at the mean point estimate as calculated by the IRO. Progenity Agendia 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 work papers) received from Progenity Agendia to the appropriate Medicare or state Medicaid program contractor for appropriate follow up by the payor.