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HPSA Overpayments in California

The Omnibus Budget Reconciliation Act (OBRA) of 1987 provided incentive payments to physicians who furnish services to Medicare beneficiaries in rural and urban Health Professional Shortage Areas (HPSAs) beginning in 1989.  The CMS website lists zip codes that will automatically receive bonus payments.  The HPSA automated file is updated annually.  Individual Medicare Administrative Contractors (MACs) provide quarterly updates on their web sites for changes to HPSA designations.  These changes include new additions to, as well as withdrawals from, the HPSA list. 

On August 1, 2013, Palmetto, the MAC for California posted on their website that a series of zip codes were incorrectly posted as HPSA eligible in 2012.  Physicians in these locales received HPSA payments in error.  Palmetto has started the recoupment process.  The following zip codes are included:

94134

     94954

     95020

     95433

     95476

94924

94956

95023

95445

95820

94937

94973

95366

95468

95824

 

Additional information on this recoupment can be found at:  http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Jurisdiction%201%20Part%20B~Browse%20by%20Topic~Claims%20Processing%20Issues%20Log~Current%20Issues~9A4QH94723?open&navmenu=%7C%7C

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