Vernaglia Discusses Delaying Refunds in Mid-Build Audit

22 March 2021 Report on Medicare Compliance News

Partner Larry Vernaglia was quoted in a Report on Medicare Compliance article, “PBDs May Want to Delay Refunds in Mid-Build Audit, Lawyer Says; Adjustments Are Tricky,” about whether hospitals with provider-based departments (PBFs) that failed CMS’ audit on the mid-build exception should delay refunding their overpayments.

Vernaglia said it’s conceivable that CMS under the Biden administration will reconsider the audit findings, which would be a relief both in terms of the money and in terms of what would be the nightmare of sorting through claims to determine which ones have to be adjusted.

“It’s premature to start making refunds,” he said. “Why would anyone write a check today if there’s a possibility CMS will change course because of a new administration?”

Vernaglia also said there’s hope for a reprieve because of the timing of the audit findings, which were announced on the last full day of the Trump administration, and the basis of the audit findings. “I don’t think it’s obvious CMS was right,” he said.

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