NEW YORK (360Dx) – Alere disclosed today that the revocation of the Medicare billing privileges for its Arriva Medical diabetes unit has been upheld by a Centers for Medicare & Medicaid Services (CMS) administrative law judge.
In October 2016, Alere was notified by CMS that Arriva's Medicare supplier billing number was being revoked and that it would be barred from re-enrolling in the Medicare program for a period of three years because it had billed for items and services for deceased Medicare beneficiaries. CMS later informed Alere that Arriva's competitive bidding contract would also be terminated.
Alere maintained that the billing issue was primarily due to errors stemming from Medicare system flaws, and Arriva sued CMS to have its billing privileges temporarily reinstated while an appeal with CMS' administrative law judge was ongoing.
However, Alere said today in a filing with the US Securities and Exchange Commission today that the administrative law judge has upheld the revocation of Arriva's Medicare enrollment.
"Unless and until its enrollment status is reactivated, Arriva Medical will be ineligible for reimbursement for any products or services furnished to Medicare beneficiaries after November 4, 2016," Alere said in the SEC filing. "If the enrollment is reactivated retroactive to November 4, 2016, we would be able to bill and be reimbursed for all covered products or services furnished since that date."
The company added that it intends to appeal the administrative law judge's decision with the US Department of Health and Human Services' Department Appeals Board.