10-Year ‘Look Back’ Proposed for Identification and Return of Medicare Part A and B Overpayments


Providers and suppliers have until April 16, 2012, to comment on the proposed rule to implement provisions of section 6402(a) of the Affordable Care Act that require “persons” receiving Medicare and Medicaid funds to report and return overpayments by the later of 60 days after the date on which the overpayment was identified or, if applicable, the date any corresponding cost report is due.

The proposed rule is important because it clarifies when and how an overpayment must be returned. If promulgated in final form as currently drafted, the rule would also subject providers and suppliers to a 10-year “look back” period, meaning providers and suppliers would have liability for the 10 years preceding the date an overpayment is received. The proposed rule has serious implications for provider and supplier operations if adopted as proposed. Providers and suppliers should consider using the public comment period to voice their concerns while it might still make a difference.

Please see full Alert below for further information.

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