News & Analysis as of

Patient Protection and Affordable Care Act (PPACA) Centers for Medicare & Medicaid Services Reporting Requirements

The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal... more +
The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal subsidies to reduce the number of uninsured citizens. less -

Final Rule Implements Quality Payment Program under MACRA

by Baker Ober Health Law on

If you are a physician, mid-level provider, or work with those providers, then you have been bombarded with new acronyms for new programs and promises to remove older acronyms from your Medicare vocabulary. Medicare...more

Catching Up With the Times: CMS Reforms Long-Term Care Facility Requirements Part III

by Polsinelli on

On October 4, the Centers for Medicare and Medicaid Services (CMS) published the biggest overhaul to federal long-term care regulations since 1991, and impacted facilities can immediately take steps to ensure they’re prepared...more

Risk Adjustment Update: CMS and the states react to insurer exits

by Dentons on

The close of 2016 will mark the end of the third full year that the Affordable Care Act (ACA) has been fully implemented. Data is available for the first two "reporting years," 2014 and 2015, for which health insurers and...more

CMS Finalizes Plan to Expand Medicare/Private Claims Data Available for Care Improvement

by Reed Smith on

CMS has published a final rule to allow organizations approved as “qualified entities” to confidentially share or sell analyses of Medicare and private-sector claims data to providers, employers, and other groups who can use...more

CMS Finalizes Rule on Reporting and Returning Medicare Overpayments

The Affordable Care Act (sometimes referred to as Obamacare) included a requirement for providers to report and return all Medicare and Medicaid overpayments within 60 days of identification. Although this requirement has...more

Next Steps: Helping Your Organization Implement the New Medicare Overpayment Rule - Part I

On February 12, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published a final rule that explains the requirements for providers and suppliers reporting and returning overpayments under Medicare Parts A & B (the...more

Center for Medicare & Medicaid Services Announces 60-Day Overpayment Rule

by Stinson Leonard Street on

The Centers for Medicare & Medicaid Services (CMS) published the Reporting and Returning of Overpayments Final Rule (Final Rule) on February 12, 2016. The Final Rule implements Section 6402(a) of the Affordable Care Act,...more

CMS Clarifies 60-Day Reporting Requirements For Medicare Parts A & B

by Williams Mullen on

The Centers for Medicare and Medicaid Services (“CMS”) has clarified the reporting requirements and lookback period for overpayments from Medicare Parts A and B in Final Rule 6037 (“Final Rule”), issued by CMS on February 12,...more

CMS Implements Final Rule on Medicare Parts A and B Overpayments

by Holland & Knight LLP on

After more than four years since the issuance of its Proposed Rule, the Centers for Medicare & Medicaid Services (CMS) will implement its Final Rule on the reporting and return of Medicare Parts A and B overpayments,...more

Final Rule Clarifies Requirements for Reporting and Returning Medicare Overpayments

Medicare Part A and B providers and suppliers should take note of new regulations recently issued by the Centers for Medicare & Medicaid Services that implement the Affordable Care Act’s 60-day rule on reporting and returning...more

CMS Finalizes Long-awaited Rule Implementing ACA’s Overpayment Reporting Requirements

by Latham & Watkins LLP on

CMS provides some clarity in Affordable Care Act final rule, but questions remain, complicating compliance efforts. On February 12, 2016, the Centers for Medicare & Medicaid Services (CMS) published a final rule (Final...more

Critical Analysis of CMS’ Final Rule Implementing the Affordable Care Act’s 60-Day "Report and Return" Overpayment Rule

On February 12, 2016, the Centers for Medicare & Medicaid Services (CMS) published a long-awaited final rule (Final Rule) implementing the Affordable Care Act’s (ACA’s) statutory requirement that certain overpayments be...more

CMS Finalizes 60-Day Rule Overpayment Regulations

by Robinson & Cole LLP on

On February 12, 2016, the Centers for Medicare & Medicaid Services (CMS) released a final rule (Final Rule) interpreting the application of Section 1128J(d) of the Social Security Act (the 60-Day Rule) to over payments...more

CMS Issues Long-Awaited Final Rule On Reporting And Returning Overpayments

by Wiggin and Dana LLP on

On February 12, 2016, the United States Department of Health and Human Services, Centers for Medicare & Medicaid Services ("CMS") issued the long-awaited Final Rule on Reporting and Returning Overpayments. The Final...more

CMS Issues Long-Awaited 60-Day Medicare Parts A and B Overpayment Final Rule

by King & Spalding on

On February 11, 2016, CMS released its much anticipated final overpayment reporting and refunding rule for Medicare Parts A and B (Final Rule). The Final Rule implements Section 6402(a) of the Affordable Care Act (ACA),...more

CMS Clarifies Rules on Reporting and Returning Overpayments

by Hinshaw & Culbertson LLP on

On February 11, 2016, the Center for Medicare and Medicaid Services (“CMS”) clarified several issues with regard to Medicare reporting and returning of self-identified overpayments. The Affordable Care Act (the "ACA"),...more

CMS Finalizes 60 Day Overpayment Rule

by Morgan Lewis on

The final rule relaxes the requirements on “identification” and look-back period. The Centers for Medicare & Medicaid Services (CMS) has released its long-awaited final rule related to the reporting and refunding of...more

CMS Sends Long-Awaited Medicare 60-Day Overpayment Rule to OMB for Final Clearance

by Reed Smith on

CMS is moving ahead on its much-anticipated final rule implementing Affordable Care Act (ACA) requirements on reporting and returning of Medicare overpayments. Under the ACA, enrolled providers and suppliers (and certain...more

Healthcare.gov: No 2015 Employer Subsidy Notices

by Balch & Bingham LLP on

On September 18, 2015, the Centers for Medicare and Medicaid Services (CMS) published a set of “Frequently Asked Questions Regarding the Federally-Facilitated Marketplace’s (FFM) 2016 Employer Notice Program.”...more

Court Imposes Potentially Unworkable Burden on Providers Under ACA's Report and Return Rule

by Baker Donelson on

In Kane ex rel. U.S. v. Healthfirst, Inc., the federal district court for the Southern District of New York (District Court or Court) provided on August 3 the first and long-awaited interpretation as to when a health care...more

CMS Publishes Final FY 2016 Update to SNF PPS Rates, Policies

by Reed Smith on

On August 4, 2015, CMS published its final rule updating Medicare skilled nursing facility (SNF) PPS rates and policies for FY 2016. CMS projects that the final rule will increase overall payments to SNFs by $430 million, or...more

In Closely Watched Case, Federal Court Upholds the Government’s Position on Provider Mandate to Report and Return Medicare and...

The Patient Protection and Affordable Care Act (“PPACA”), signed into law on March 23, 2010, included a provision (the “Report and Refund Mandate”), broadly requiring health care providers, suppliers, Part D plans and managed...more

Proposed Rule's Medicaid Managed Care Medical Loss Ratio Requirement Will Likely Impact Plans, Providers and Patients in New York

by Proskauer Rose LLP on

On June 1, 2015, the Department of Health and Human Services Center for Medicaid and Medicare Services (CMS) published a proposed rule at 80 Fed. Reg. 31097 (Proposed Rule) that will fundamentally change state Medicaid...more

CMS Delays Publication of Final Rule Regarding Reporting and Returning of Medicare Overpayments

by Foley & Lardner LLP on

One of the most challenging compliance changes brought about by the Affordable Care Act (ACA) is the provision mandating the reporting and refunding of Medicare and Medicaid overpayments within 60 days of the date they are...more

A Brave New World of Transparency Reporting: CMS Launches Open Payments Website

September 30th marked the launch of transparency reports under the Sunshine Act through a new Open Payments website hosted by the Centers for Medicare & Medicaid Services (CMS)....more

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