HMA has identified underpayments from Tufts Medicare Preferred (TMP) 2021 through our normal client Billing and Payment Review process. Multiple billing companies have confirmed that the 2021 TMP payment rates match incorrect CMS rates that were issued early in December of 2020 but were rescinded shortly thereafter.
The lower CMS rates were formally recalculated and corrected via email by CMS on December 27, 2020 to higher payment rates. TMP did not implement the corrected rates resulting in underpayments varying in degree by CPT code from 3% to 12% lower than the corrected, CMS issued rates.
Over the past few months, HMA personnel have been working with client billing companies to reach out to TMP and have them correct these underpayments. We are pleased to report that adjusted payments have recently been received for some clients and two separate billing companies have confirmed that TMP has stated that they will be reprocessing all impacted claims.