Maleaka Guice and Anna Grizzle Comment on Impact of CMS Recoupment Process

February 22, 2019
The Atlanta Journal-Constitution

Bass, Berry & Sims attorneys Maleaka Guice and Anna Grizzle provided comments for an article in The Atlanta Journal-Constitution about the impact to hospitals that challenge Medicare payment disputes. The article highlighted the struggle that Roosevelt Warm Springs Rehabilitation Hospital is experiencing related to the Centers for Medicare and Medicaid Services (CMS) claim that the hospital over charged CMS for care and should repay these expenses. Until the hospital repays the money, CMS is withholding any Medicare reimbursements – a common practice known as recoupment. However, due to a backlog of recoupment claims nationwide, the Roosevelt hospital is uncertain when their challenge will be heard and is now facing loss of vital Medicare payments to continue operating.

“It’s an especially draconian measure in that if the facility is challenging the audit, they often complete recoupment before they exhaust their appeals,” said Anna, speaking of the CMS process to challenge the overpayment claims. As Maleaka added, “It’s a lack of due process to wait three to five years to go in front of a neutral judge.”

The full article, “Medicare Payment Dispute Imperils Georgia Hospital with FDR Legacy,” was published by The Atlanta Journal-Constitution on February 21, 2019, and is available online.