News & Analysis as of

Overpayment Medicare Final Rules

King & Spalding

CMS Issues Final Rule on Medicare Advantage Risk Adjustment Data Validation Program

King & Spalding on

On February 1, 2023, CMS published its final rule addressing the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. CMS uses RADV audits to identify whether Medicare made overpayments to MA plans by...more

Bass, Berry & Sims PLC

CMS Finalizes Long-Awaited RADV Program Rule

On February 1, the Centers for Medicare & Medicaid Services (CMS) published the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) Program Final Rule (Final Rule), which will take effect on April 3, 2023. The...more

Troutman Pepper

CMS Publishes Final Rule Increasing Government Authority to Recover Overpayments from Medicare Advantage Plans

Troutman Pepper on

On February 1, the Centers for Medicare & Medicaid Services (CMS) published a final rule strengthening their authority to recover alleged overpayments made to Medicare Advantage plans. The rule formalizes the Medicare...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 17. News Briefs: May 2021

Report on Medicare Compliance 30, no. 17 (May 3, 2021) - In a new provider compliance audit, the HHS Office of Inspector General (OIG) said Visiting Nurse Association of Maryland (VNA) received overpayments of $2.1...more

Dickinson Wright

Physician Compliance Programs: What you need to know about the Final 60-Day Rule

Dickinson Wright on

The 60-Day Rule was enacted as part of the Affordable Care Act on March 23, 2010 and generally requires a person who has received an overpayment to report and return the overpayment by the later of (i) the date which is 60...more

King & Spalding

CMS Issues Long-Awaited Final 60-Day Overpayment Rule

King & Spalding on

On February 11, 2016, CMS released its eagerly awaited final overpayment rule for Parts A and B. The Final Rule responds to significant concerns voiced by the provider community and, in some respects, is more workable than...more

Baker Donelson

Final 60-day Overpayment Rule

Baker Donelson on

On February 12, 2016, CMS published a final rule addressing compliance with Section 1128J(d) of the Social Security Act. Section 1128J(d), which was added when the Affordable Care Act was enacted on March 23, 2010, imposes a...more

Hinshaw & Culbertson LLP

CMS Clarifies Rules on Reporting and Returning Overpayments

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

Dorsey & Whitney LLP

CMS Finalizes Rule Requiring Healthcare Providers to Return Overpayments

Dorsey & Whitney LLP on

On February 12, 2016, the Centers for Medicare & Medicaid Services (CMS) published its final rule regulating how healthcare providers must report and return overpayments. This rule implements the Affordable Care Act’s...more

Holland & Knight LLP

CMS Announces Final Regulatory Changes to Medicare Advantage and Part D

Holland & Knight LLP on

- CMS issues final Medicare Advantage and Part D regulatory changes after a controversial proposed rule was announced earlier this year. - New requirements for the reporting and return of Medicare Advantage and Part D...more

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