Tag Archives: overpayment

15 Sep

Appeal of UPIC Audit Overpayment Determinations – A Multi-Step Approach

Mr. Gaitan is available to discuss his strategies and legal costs, including hourly and contingency fee arrangements with provider’s who have received a records request or have received an overpayment determination and demand letter from their MAC or would like to more about the process. Initial consultation fee is waived. Feel free to contact Rafael (Ralph) Gaitan, Esq. at (786) 440-8115 or via email at [email protected]

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18 Oct

Changes to the Amount in Controversy Thresholds for Medicare Appeals

Beginning on or after January 1, 2020, the amount in controversy needed by Medicare providers will change as follows: $170 for Administrative Law Judge (ALJ) hearings. (2019 – $160) $1,670 for judicial review (2019 – $1,630) The Center for Medicare and Medicaid Services (CMS) every year announces annual adjustments to the amount in controversy threshold

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23 Aug

Gaitan Law Group Successfully Reduces a $736,305.93 Overpayment to $6,826.00

  CMS sought recovery of an alleged overpayment in excess of $730,000 from a diagnostic laboratory, upon the conclusion and recommendation of Safeguard Services (SGS) to deny all claims submitted for 3,006 Medicare beneficiaries.  Mr. Gaitan and Mr. Suarez, of our health care practice group, appealed the overpayment claim through the reconsideration (second level appeal),

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