WHCA/WiCAL has been made aware of a potential issue that we wanted to bring to members’ attention: we are aware of at least three instances where facilities have received an “amount due and payable” letter from CMS-Chicago in which the letters did not reflect the 35% CMP reduction that should have been applied after the facilities timely submitted a waiver of a hearing.

It appears that CMS-Chicago is in the process of clearing its backlog of prior CMP imposition determinations. Facilities are receiving CMP imposition letters for surveys conducted in 2022 (and possibly earlier). We have received confirmation from providers that some CMP “payable” letters instruct that the fully amount of CMP is due and payable, without factoring in the 35% reduction to which the facility was eligible.

WHCA/WICAL strongly encourages member providers to thoroughly review and document both CMP imposition letters and subsequent “amount due and payable” letters to ensure that CMS is honoring the 35% reduction when applicable.

If you determine that your “due and payable” letter includes an incorrect amount, please reach out to the appropriate CMS contact listed in the letter as soon as possible.