OMIG Sends TPL Reminder
Last week, select home health providers should have received a letter from the Office of the Medicaid Inspector General (OMIG) Bureau of Third Party Liability and Contract Review reminding them to bill Medicare for specified cases for individuals dually eligible for Medicare and Medicaid. This is a follow-up letter to an Aug. 11th letter that first identified the cases for which the organization was being instructed to bill Medicare. The claims that were selected for this initiative fall between Oct. 1, 2016 and March 31, 2017 and can include both fee-for-service and Episodic Payment System (EPS) claims.
Providers that did not receive a letter, as well as those who received the letter and have already billed Medicare pursuant to the letter's instructions, need not take any action. Those who did receive the letter and have not yet billed for the specified cases should do so as soon as possible.
OMIG has contracted with the University of Massachusetts (UMass) Medical School to perform this Medicare Home Health Appeals Initiative, which is geared to ensure that providers bill Medicare and any other appropriate third party prior to billing Medicaid. Questions about the initiative should be addressed to Laurie Burns of UMass at 866-626-7594.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841