Repayment of Identified Overpayments Contract Clauses (8)

Grouped Into 2 Collections of Similar Clauses From Business Contracts

This page contains Repayment of Identified Overpayments clauses in business contracts and legal agreements. We have organized these clauses into groups of similarly worded clauses.
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 shal...l 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. B. Claims Review Report. The IRO shall prepare a Claims Review Report as described in this Appendix for each Claims Review performed. The following information shall be included in the Claims Review Report. View More
Found in PROGENITY, INC. contract
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"). 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. B. Claims B.Claims Review Report. The IRO shall prepare a Claims Review Report as described in this Appendix for each Claims Review performed. The following information shall be included in the Claims Review Report. View More
Found in Universal Health Services, Inc. contract
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Repayment of Identified Overpayments. CareMed shall repay within 30 days any Overpayment(s) identified in the Discovery Sample, regardless of the Error Rate, and (if applicable) the Full Sample, including the IRO's estimate of the actual Overpayment in the Population as determined in accordance with Section A.3 above, in accordance with payor refund policies. CareMed shall make available to OIG all documentation that reflects the refund of the Overpayment(s) to the payor. 44 B. Claims Review Report. The IRO shall prepare a Claims Re...view Report as described in this Appendix for each Claims Review performed. The following information shall be included in the Claims Review Report for each Discovery Sample and Full Sample (if applicable). View More
Found in PharMerica CORP contract
Repayment of Identified Overpayments. CareMed CCH of New York shall repay within 30 60 days any Overpayment(s) identified in the Discovery Sample, regardless of the Error Rate, and (if applicable) the Full Sample, including the IRO's estimate of the actual Overpayment in the Population as determined in accordance with Section A.3 A.3, above, in accordance with payor refund policies. CareMed CCH of New York shall make available to OIG all documentation that reflects the refund of the Overpayment(s) to the payor. 44 B. Claims B.Claims... Review Report. The IRO shall prepare a Claims Review Report as described in this Appendix B for each Claims Review performed. The following information shall be included in the Claims Review Report for each the Discovery Sample and the Full Sample (if applicable). View More
Found in Amedisys Inc contract
Repayment of Identified Overpayments. CareMed shall 21st Century shal1 repay within 30 days any Overpayment(s) identified in the Discovery Sample, Samples, regardless of the Error Rate, and (if applicable) the Full Sample, Samples, including any extrapolated Overpayments determined by the IRO's estimate of the actual Overpayment in the Population as determined IRO in accordance with Section A.3 above, in accordance with payor refund policies. CareMed 21st Century shall make available to OIG all documentation that reflects the refund... of the Overpayment(s) to the payor. 44 B. Claims Review Report. The IRO shall prepare a Claims Review Report as described in this Appendix for each Claims Review performed. The following information shall be included in the Claims Review Report for each Discovery Sample and Full Sample (if applicable). View More
Found in 21st Century Oncology Holdings, Inc. contract
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