Last fall’s Mcare settlement requires that $200 million be returned to physicians, hospitals, and other health care providers. This includes $139 million in refunds for prior assessment overpayments for 2009, 2010, 2011, 2012, and 2014.
- Who is eligible to receive refunds?
- How are refunds calculated?
- Are physicians required to remit their refund to another person or entity that paid the assessment, such as a medical practice or hospital?
- What should physicians and medical practices do over the next few months to protect their interests?
These are some of the questions the Pennsylvania Medical Society (PAMED) attempted to answer in a new website, www.McareRefund.org, which debuted April 1.
The first round of refund checks are tentatively scheduled to be sent to physicians in the first quarter of 2016.
But to ensure that they make informed decisions and receive payment of refunds that they are entitled to keep, physicians need to understand several possible scenarios and actions that could arise from those scenarios.
For example, a person or entity that paid the assessment for the physician may make a claim on that refund. The claim period has started and runs through Aug. 19. Physicians will be notified of a claim through the mail – tentatively scheduled for the fall of 2015 – and will be directed to a website where they must choose whether a claimed refund should be paid to them or have Mcare pay the claimant.
A person or entity that paid your refund also may ask you to fill out an assignment agreement if it did not make a claim on the refund. Medical practices and other assessment payors are permitted to begin asking for assignment agreements once they obtain the required forms from Mcare. The form to request these assignment agreement forms is now available on the Mcare website.
The www.McareRefund.org website that PAMED created was designed to give physicians and medical practices the proper information to help them understand these scenarios and make the best decision.
PAMED also has a webinar on www.McareRefund.org that provides an overview of the Mcare refund process.