Overpayment

News & Analysis as of

Sixth Circuit Refuses To Permit Judicial Review Prior To Conclusion Of Reinsurance Arbitration Proceeding

The Sixth Circuit recently reversed a district court’s decision to stay arbitration proceedings in a dispute concerning allegations of overbilling on a reinsurance program. The arbitration clause from the treaty established a...more

Medicare’s 60-Day Proposed Refund Rule Imposes Significant Liability on Providers

As part of the Affordable Care Act, Congress outlined the process for providers to return Medicare and Medicaid overpayments. In 2012, CMS proposed the 60-day Refund Rule, as it is commonly known, requiring Medicare providers...more

Interest On Tax Overpayments–Not Always Available

Code §6611 provides that the IRS will pay interest on tax overpayments back to the due date if the overpayment is not refunded within 45 days of the refund claim (or within 45 days of the return due date for a timely filed...more

Third Circuit Holds Judicial Review of Extrapolated Overpayment Determinations is Precluded

On February 12, 2014, the U.S. Court of Appeals for the Third Circuit held that Federal courts do not have jurisdiction to review HHS’s determination of a “sustained or high level of payment error,” one of two possible...more

Streamlined RAC Appeal Processes Lead To Winning Legal And Economic Outcomes

Armed with the Recovery Audit Contract (RAC) Program, the Federal government has been very successful in recouping Medicare overpayments from health care providers in recent years. During a RAC audit, program contractors...more

Proposed Overpayment Reporting Requirements for MA and Part D Programs May Increase False Claims Act Liability

The Centers for Medicare & Medicaid Services continues to take an expansive view of the overpayment refund requirement, which in turn can give rise to False Claims Act liability for Medicare Advantage Organizations and Part D...more

False Claim Act: 2013 Year in Review

Last year continued the trend of robust False Claims Act (FCA) enforcement by the U.S. Department of Justice (DOJ) and proliferating qui tam lawsuits brought by whistleblowers on behalf of the United States. In 2012, DOJ...more

CMS Issues Refunds For Collections Made On Incorrectly Identified Incarcerated Beneficiary Overpayments

Medicare does not cover supplies or services for persons who are incarcerated at the time the services are rendered. However, Medicare had purportedly paid providers in error for many such claims and sought to recover those...more

OIG Recommends that CMS Scrutinize Clinicians with High Cumulative Payments

Focusing on clinicians who receive high cumulative payments under Medicare Part B could be a useful means of identifying possible improper payments, according to a recent report issued by the Office of Inspector General of...more

IRS Tax Overpayment And Underpayment Interest Rates–1st Quarter 2014

Please see full chart below for IRS Tax Overpayment And Underpayment Interest Rates for the 1st Quarter of 2014....more

Credits for Overpaid Taxes Affirmed

A divided panel of the Commonwealth Court affirmed a decision below that taxpayers were entitled to credits for overpaid Philadelphia Business Privilege Tax, notwithstanding a three-year limit on the refund of taxes. City of...more

Extrapolated Medicaid Audits Continue: Be Proactive! (Or Move to West Virginia)

Extrapolated audits are no fun, unless you work for a recovery audit contractor (RAC). You get a Tentative Notice of Overpayment (TNO) that says the auditor reviewed 100 dates of service (DOS), found an overpayment of...more

Southeast State & Local Tax: Important Developments - November 2013

The Williams Mullen Southeast State and Local Tax (SESALT) team is pleased to provide you with a comprehensive recap of recent legislation around the U.S....more

NYS Department of Labor Issues Regulations Expanding Allowable Wage Deductions

The NYS Department of Labor issued final regulations for the November 2012 amendments to Labor Law § 193, expanding permissible employer wage deductions. The regulations, 12 NYCRR Part 195, became effective on October 7,...more

NY DOL Issues Final Wage Deduction Regulations

The NY DOL’s final regulations regarding an employers’ ability to reduce employee wages for overpayments recently took effect. Consistent with the DOL’s proposed regulations, which we discussed here, the final regulations...more

Update: New York Department of Labor Issues Final Wage Deduction Regulations

As we detailed in a previous posting (available here), in September 2012, Governor Cuomo signed into law new legislation which permits employers to make additional deductions from employees’ paychecks. Among other things, the...more

NYS Identifies $496 Million in Medicaid Home Health Erroneous Payments

On October 30, 2013, the New York State Office of the Medicaid Inspector General (“OMIG”) issued a press release that New York recovered $211 million from the federal government out of an identified $496 million in Medicaid...more

New York Department Of Labor Issues Final Wage Deduction Regulations

As we previously posted, last year New York amended New York Labor Law §193 (“NYLL”) to expand the scope of permissible deductions an employer may make from an employee’s paycheck. Even though the amendments became effective...more

New York State now allows employers to make payroll deductions for inadvertent overpayment of wages

Section 193 of the New York Labor Law proscribes an employer’s right to make deductions from its employees’ paychecks with very limited exceptions. In November 2012, the law was amended to allow employers to make payroll...more

Certain Deductions Allowed Under New York Labor Law, But Employers Beware

The New York State Department of Labor (“NYSDOL”) issued final regulations last week governing how employers may make certain types of deductions from employee wages authorized under the New York Labor Law. For years, there...more

New York Wage Deduction Rules Take Effect

The regulations provide employers with specific guidelines for wage deductions, including those for overpayments and advances. On October 9, the New York Department of Labor’s (NYDOL’s) final wage deduction regulations...more

New Wage Deduction Regulations Finalized by New York State Department of Labor

On October 9, the New York State Department of Labor’s final wage deduction regulations took effect. Those regulations are codified at 12 N.Y.C.R.R. 195, and are available here. The final regulations are very similar to the...more

A Real-Life Analysis Of The New Wage Deduction Rules In New York: What The Legislature Giveth, The Regulators Have Taketh Away

Last week, the New York State Department of Labor issued regulations to implement the 2012 amendments to New York’s wage deduction law. The amendments were enacted to facilitate employer deductions of overpayments and...more

New York Employers Are Now Safe to Make Wage Deductions: NYDOL Issues Final Wage Deduction Regulations

The New York Department of Labor (NYDOL) issued final regulations, effective October 9, 2013, which explain how and when employers may make deductions for wage overpayments due to mathematical or clerical errors and for...more

Two New Measures in New York: Wage Deduction Rules and Pregnancy Accommodation

Most employers tend to focus on federal law as a source of labor and employment obligations. However, employers should also pay careful attention to state and local laws on workplace issues. The first half of this month has...more

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