Common use of Repayment of Identified Overpayments Clause in Contracts

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

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

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

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

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