The Medicare Overpayment Rule: Implications for Compliance and Health Care Enforcement

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As has been widely discussed, the Centers for Medicare & Medicaid Services (‘‘CMS’’) Feb. 12 published the long-awaited final rule governing the return of Medicare Part A and Part B overpayments within 60 days (the ‘‘Overpayment Rule’’). The Overpayment Rule implements Section 6402(a) of the Affordable Care Act, which established section 1128J(d) of the Social Security Act (the ‘‘Act’’). The Act requires that an overpayment be reported and returned by the later of (A) the date which is 60 days after the date on which the overpayment was identified; or (B) the date any corresponding cost report is due (if applicable).

The proposed rule, which was published four years ago, led to a great deal of consternation among providers and suppliers, and thus it is no surprise that CMS received over 200 comments.

Originally published in Bloomberg BNA’s Medicare Report, 27 MCR 185, 2/26/16.

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