U.S. Court of Appeals sets January for arguments over erroneously sent Medicare

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U.S. Court of Appeals sets January for arguments over erroneously

sent Medicare premium reimbursements after holding lower court's

decision

http://www.news-medical.net/?id=20440

The U.S. Court of Appeals for the District of Columbia Circuit on

Wednesday issued a temporary hold on an order by a lower court that

CMS must inform 230,000 Medicare beneficiaries who received erroneous

reimbursements of their Medicare prescription drug benefit premiums

of their right to request a waiver of recovery of the funds, the

Washington Post reports.

In addition, under the hold, CMS does not have to return erroneous

reimbursements recovered from the affected Medicare beneficiaries

immediately (Washington Post, 10/6). The affected Medicare

beneficiaries received a total of $50 million in erroneous

reimbursements in August as the result of a computer error. In

response, CMS sent letters to the affected Medicare beneficiaries

that instructed them to return the erroneous reimbursements, which

averaged $215, to the federal government by Sept. 30. T

he Gray Panthers and the Action Alliance of Senior Citizens last

month filed a lawsuit that seeks to block the required return of the

erroneous reimbursements. According to the lawsuit, federal law

allows for waiver of recovery of funds when beneficiaries are not at

fault for overpayments. U.S. District Court Judge Henry Kennedy on

Sept. 28 ordered CMS Administrator Mark McClellan to send letters

immediately to the affected Medicare beneficiaries to inform them of

their right to request a waiver under federal law. In addition, he

said that erroneous reimbursements returned to the federal

government " must be immediately returned to the beneficiaries so that

they may decide whether to request waiver " (Kaiser Daily Health

Policy, 9/29). CMS appealed the decision (Freking, AP/Houston

Chronicle, 10/5).

Temporary Hold

The appeals court issued the temporary hold to allow a three-judge

panel to review arguments in the lawsuit (Washington Post, 10/6). The

court also scheduled a trial for January. CMS officials said that the

agency will continue efforts to recover erroneous reimbursements from

the affected Medicare beneficiaries. According to the AP/Chronicle,

CMS to date has recovered erroneous reimbursements from about half of

the affected Medicare beneficiaries. McClellan said, " CMS remains

flexible in working with each beneficiary to resolve their premium

payment issue, " adding, " This includes providing the option of making

premium payments over many months if that is what the beneficiary

prefers " (AP/Houston Chronicle, 10/5).