Late Development of Therapy Threshold Cap Additional Development Requests (ADR’s)

CMS provided direction that February 28 is the last day a MAC may send Pre-Payment ADRs for the Recovery Auditor Prepayment Review Demonstration.

Due to the timing of system processing for Pre-Payment review activity, the late development of ADR’s were processed after February 28, 2014. If you receive a Pre-Payment ADR dated 2/28/2014 or after from Novitas, please disregard this request. You do not have to submit the Medical Records to the Recovery Auditor at this time. Claims that hit the threshold as of 2/28/2014 are still subject to Post Payment review by the Recovery Auditor. You must respond to any subsequent Post Payment request for documentation from the Recovery Auditor.