Category Archives: Overpayment

11 Feb

How to respond to a Final Audit Report (FAR)

Florida health care providers that provide services to Medicaid recipients are likely, at some point, to receive an audit of their claims submitted to the Medicaid program for reimbursement. Some providers will, for any number of reasons, receive a preliminary audit report detailing the Agency for Health Care Administration’s (Agency) findings as well as setting

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07 Feb

Responding to Record Requests on a Timely Basis.

Health care providers are increasingly seeing request for records from all types of payors including but not limited Medicaid, Medicare and commercial insurance providers. The basis for receiving a requests for records could be as a result on any number of reasons, including compliance, aberrant billing practices or as a result of a ZPIC audit

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07 Feb

Florida Behavior Analysis Services – Overpayments

The Florida Agency for Health Care Administration (Agency), Medicaid Program Integrity (MPI) has and is undergoing review of several Behavior Analysis Services providers regarding their Medicaid reimbursement claims for services rendered. MPI is reviewing said claims in order to insure compliance with the program’s Florida Medicaid Behavior Analysis Services Coverage Policy dated October 2017, including

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17 Sep

AHCA Increases Efforts to Collect Medicaid Overpayments

On September 16, 2014, Florida’s Agency for Health Care Administration (AHCA) issued a notice to Medicaid providers informing that “in the upcoming weeks the Agency will increase its efforts to ensure that providers are repaying overpayments”, while also reminding Medicaid providers of “their obligation to promptly refund moneys due to [AHCA], including any moneys received

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