CMS Unable to Recover Alleged Overpayment Due to Delay

In a complex case involving delays, oversights, and improper proceedings by CMS contractors, U.S. Administrative Law (ALJ) Judge Barry H. Jenkins recently ruled that CMS was not entitled to recovery of an alleged Medicare overpayment for rehabilitation services furnished at a Texas skilled nursing facility. This important precedent shows that CMS must act in a timely manner if it believes an overpayment has been made. If not, then the provider may have an avenue of defense against claims of overpayment.

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