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July 22, 2021

Are All Incorrect Medicare Payments Overpayments?

On June 18, an ALJ with the Office of Medicare Hearings and Appeals agreed with a DME supplier that unpaid and underpaid claims should be included in the extrapolation for auditing purposes. Former Medicaid Integrity faculty member Burce Truitt noted that all overpayments are improper payments, but not all improper payments are overpayments, and ifunderpayments are not included, you never get to the correct value of the claim and the true dollar value is not properly determined. . However, OIG indicated that including these claims may ultimately result in providers owing more than they otherwise would if the OIG did not include the unpaid or underpaid claims.