What is the RDS Annual Reconciliation?
Plan Sponsors that have received or are expecting reimbursement from Medicare under RDS must go through a mandatory reconciliation process. The reconciliation process is the validation of eligibility compared with CMS records. For accounts that have already received interim payment, the interim costs are compared to the final costs. If the final costs exceed the interim reporting, then CMS will pay the difference to the Plan Sponsor. Conversely, if the reported costs exceed the final costs, then CMS will seek recovery for the difference. Failure to timely file reconciliation will result in a denial of all payments to the Plan Sponsor and will trigger recovery by CMS of any interim payments, possible interest penalties, and fines.
