Medicare Claims Processing Manual (Pub. 100-04), Ch. 30 § 150.5
Supplier Knowledge Standards for Waiver of Refund
150.5 - Supplier Knowledge Standards for Waiver of Refund
Requirement
(Rev. 1, 10-01-03)
A refund is not required of the supplier if the supplier did not know and could not
reasonably have been expected to know that Medicare would not pay for the medical
equipment or supplies. Following are the knowledge standards applicable to the different
types of denials.