Another court issues TRO on CMS

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Tuesday, July 24, 2018

BROWNSVILLE, Texas – A court has again issued a temporary restraining order prohibiting CMS from recouping overpayments until after the administrative law judge level, this time on behalf of Adams EMS, according to healthcare attorney Elizabeth Hogue. In June, the U.S. District Court for the Northern District of Texas issued a TRO on behalf of Family Rehabilitation. In this most recent case before the U.S. District Court for the Southern District of Texas, Health Integrity, a ZPIC, determined that Adams EMS received $148,035 in overpayments on claims submitted from July 17, 2012, to Jan. 15, 2016, an amount it extrapolated to $418,035. Adams successfully argued that it was being deprived of due process because of the massive backlog at the ALJ and that recoupment before it had its day in appeals court would put the company out of business. “So there it is; yet another court decision granting relief for providers from recoupments,” Hogue wrote in an email bulletin. “Providers now have tools that they didn’t have before. Use them to protect your patients, businesses and employees.”