2010 Compliance Review -- What Did I Miss?

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The Red Flags Rule

The rules have been modified that "creditor" no longer includes any business that extends credit or permits payment plans for fees incident to its services. Because healthcare providers are no longer "creditors" under this law, healthcare providers no longer need to comply with the Red Flags Rule.

The Stark Self-Disclosure Protocol

Published March 23, 2010, the Stark Self-Disclosure Protocol outlines how providers are to disclose actual or potential Stark violations. There was no disclosure requirement prior to these new criteria.

New Refund Requirements include False Claims Act consideration

The Patient Protection and Affordable Care Act ("PPACA"), explicitly states that "[a]ny overpayment retained by a person after the deadline for reporting [60 days] and returning the overpayment [] is an obligation [under the False Claims Act]." An overpayment must be reported by the later of sixty days after the date on which the overpayment was identified or the date any corresponding cost report is due. Thus, retention beyond this period may subject the retaining person or entity to liability under the False Claims Act. Considering the steep penalties, up to $11,000 per claim plus treble damages, and Congress' direct link from PPACA to the False Claims Act, health care providers and others receiving federal money must proceed with caution and enhanced vigilance.

Please see full update below for more information.

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Published In: Administrative Agency Updates, Business Organization Updates, Finance & Banking Updates, Health Updates, Privacy Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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