Medicare and state law

Hi
Medicare has just requested a refund on a claim for a March 2007 date of service. Per their filing guidelines, we would have had until December 31, 2008 to file the claim. Louisiana law states that insurance companies have as long to request a refund as providers have to file the claim. So, per Louisiana law, the deadline to request a refund was 12/31/08.
A customer service rep at Medicare says they do not conform to Louisiana/local laws because they are a federal agency. However, state law does supersede federal law in the case of rights and protection of the patient.
My question is: Does state law supersede federal law in this case as well, i.e., does Medicare have to conform to their own deadline in requesting a refund per Louisiana Law?
Thanks,
Kim

i have no answer for you but...

I am curious- do you want to share what you billed and why they are asking for a refund?

Medicare and state law

[I am curious- do you want to share what you billed and why they are asking for a refund?]

We billed an x-ray during post op. Pt was apparently enrolled in a skilled nursing facility at the time, but was seen in our office for after-care.

Medicare and state law

Was this denied as part of Consolidated Billing? Unfortunately, that makes sense, and I don't think you'll be able to do anything to recoup that money.

http://www.codapedia.com/~article_353_.cfm

It's all in the details

[[I am curious- do you want to share what you billed and why they are asking for a refund?]

We billed an x-ray during post op. Pt was apparently enrolled in a skilled nursing facility at the time, but was seen in our office for after-care.]


As the Editor pointed out, your xray should have been paid by the SNF. The good news though is that you could go back to the SNF and ask for payment now. Your professional fee should have been paid by Medicare- Consolidated billing only applies to non-physician services.

My experience

Unfortunately, every time Medicare asks us for a refund we either have to give it to them or they will take it out of one of our future checks. Usually they take it out of us because the patient may have gotten a Medicare fee for service product and not told us. We have learned our lesson about paying back insurance carriers. Never do it. They take it out anyway and never can seem to find our payments. It doesn't seem they have to play by the state laws in my state.

Correction

I stand corrected - Medicare will not take it out of future checks, they will tack on interest. In fact, I, too, just received a request from 2006. My request was received because Medicare paid and the patient was in a nursing home. We do not send money back to commercial carriers. We paid BCBS back in 2006 and in 2008, they nipped the same amount again from us and we haven't been successful in getting the money back.