HHSOIG - A-07-19-05117 - 270626

We recommend that the Centers for Medicare & Medicaid Services direct the Medicare contractors to review the 1,598 claims totaling $289,169 in MCPs for potentially duplicate claims and $74,563 in associated beneficiary cost sharing (deductible and coinsurance amounts) and determine which of the claims should have been denied as a duplicate claim for ESRD-related services and o recover the portion of any MCPs from the physicians for claims for duplicate services (that are within the 4-year reopening period), and o instruct the physicians to refund beneficiaries the portion of the deductible and coinsurance amounts that may have been incorrectly collected from beneficiaries or from someone on their behalf