You can expect to see overpayment demands from CMS between now and November for Part B claims processed after April 1, 2011, the agency says. On April 1, CMS implemented a change request (CR 7026) that allowed its Common Working File to accept both Medicare as secondary payer (MSP) data and non-MSP data in claims adjustment lines.
In English: Any patient who hasn't met the Medicare deductible, but has Medicare as the secondary payer, was issued coverage and had services paid as if the deductible were met, for claims processed anytime after April 1, 2011, CMS says. The resulting overpayments will be recouped by CMS "systematically" and should be done by November, the agency says.
On top of the overpayments, all MSP claims for physical and occupational therapy processed after April 1, for which the deductible was not met, have been held and will not be paid until the overall MSP snafu is resolved, again by November, CMS says.