Provider prevails after typo threatens $250,000 in Medicare funding

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A New York cancer treatment center won't have to give up $250,000 in Medicare funding after making a clerical error, federal officials decided last week.

The Centers for Medicare & Medicaid Services originally ruled to reduce Medicare reimbursements for Hematology-Oncology Associates of CNY by more than $250,000 after a staff member entered “IP” into records it submitted to the health agency instead of “1P.”

The “IP” listing caused Hematology-Oncology Associates quality score to drop, which would have led to the steep drop in funding. CMS ruled against a revision of the records, even though the provider argued the typo was clearly unintentional.

CMS' ruling caught the attention of Senate Minority Leader Chuck Schumer (D-NY) and Rep. John Katko (R-NY), who wrote to CMS Administrator Seema Verma with concerns about the error's “disastrous impact.”

“We believe reducing their Medicare reimbursement by over $250,000 due to a data entry error seems overly punitive,” the lawmakers wrote. “It does nothing to advance the interests of the Medicare and Medicaid programs, and it does not reflect congressional intent regarding the Value Modifier Program.”

Schumer and Katko announced on Wednesday that CMS decided to reverse its decision, preserving Hematology-Oncology Associates' current level of funding.

Maryann Roefaro, CEO of Hematology-Oncology Associates, told The Citizen newspaper in Auburn, NY, that CMS' original decision could have led to staffing cuts.

“The designation and loss of revenue from CMS as a result of a clerical error was unconscionable, and to say we are all grateful for this correction is an understatement," Roefaro said.