News & Analysis as of

Patient Protection and Affordable Care Act (PPACA) › 60-Day Rule

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 -
Health Care Compliance Association (HCCA)

Credible Information Is Heart of 60-Day Rule; OIG: Self-Disclosure Pauses the Clock

Health Care Compliance Association (HCCA) on

Report on Medicare Compliance 30, no. 28 (August 2, 2021) - When a hospital realized it had been billing for annual wellness visits without documentation of opioid and substance use screening, it wasn’t a heavy lift to...more

Ruder Ware

Apply the 60-Day Rule to Medicaid Overpayments

Ruder Ware on

The Affordable Care Act requires any person who has received an overpayment from certain defined government health programs to report and return the overpayment within 60 days after the overpayment is identified. If an...more

Bricker Graydon LLP

A 60-Day Overpayment Refund Rule update

Bricker Graydon LLP on

The 60-Day Overpayment Refund Rule (60-Day Rule) was enacted as Section 6402 of the Affordable Care Act (ACA) on March 23, 2010. ...more

Roetzel & Andress

Federal Court Overturns CMS Overpayment Rule

Roetzel & Andress on

A recent ruling by a federal district court could have a significant impact on how certain health insurers, specifically those providing coverage pursuant to Medicare Parts C (i.e., Medicare Advantage insurers) and D (i.e.,...more

Arnall Golden Gregory LLP

Court Nixes CMS’s Negligence Standard for Applying False Claims Act Liability for Failure to Report and Return Overpayments

Arnall Golden Gregory LLP on

In what has become widely known as the “60-day rule,” the Affordable Care Act (ACA) requires that Medicare and Medicaid overpayments be reported and returned within the later of the date which is 60 days after the date on...more

Chambliss, Bahner & Stophel, P.C.

Reminder: Medical Providers Must Be Attentive to Credit Balances and Other Overpayments

Chambliss, Bahner & Stophel, P.C. on

It has now been a number of years since the enactment of Section 6402(a) of the Affordable Care Act ("ACA"), which requires among other things that any recipient of a Medicare or Medicaid overpayment report and return it...more

Dickinson Wright

Preventing Overpayments from becoming False Claims

Dickinson Wright on

Overpayments to healthcare providers receiving Medicare reimbursements are at risk of civil and criminal enforcement action if not attuned to a particular reimbursement rule and diligent in compliance with the rule’s...more

Ruder Ware

Repayment and Self Disclosure of Known Overpayments

Ruder Ware on

The 60-day repayment rule adopted as part of the Affordable Care Act is a very strong arrow in the quiver of federal enforcement agencies. Under the 60-day rule a known overpayment can become a False Claim if it is not repaid...more

Burr & Forman

2016 Health Care Year in Review

Burr & Forman on

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

Baker Donelson

Update on First 60-Day Case

Baker Donelson on

A settlement was reached on August 23, 2016, in U.S. ex rel. Kane v. Healthfirst, Inc., et al., No. 11 CIV. 2325 (ER) (SDNY), a little over one year after the judge in that case issued the first judicial interpretation of the...more

Alston & Bird

Raising Kane: CMS’s 60-Day Rule Commands More Than Treble Damages

Alston & Bird on

In August 2015, we published a client advisory on the first judicial opinion interpreting the Affordable Care Act’s (ACA) “60-day overpayment rule,” which requires providers to “report and return” an overpayment of Medicare...more

Robinson & Cole LLP

Health Law Pulse - September 2016

Robinson & Cole LLP on

DOJ, NY AG REACH SETTLEMENT WITH HOSPITALS IN LANDMARK 60 - DAY RULE CASE - On August 24, 2016, the U.S. attorney for the Southern District of New York and the New York State attorney general announced a $2.95 million...more

Foley & Lardner LLP

The Top 10 Things you Need to Know About Voluntary Disclosures and Government Refunds

Foley & Lardner LLP on

In February 2016, CMS issued the highly anticipated Final Rule on reporting and returning Medicare Part A and B overpayments. The Final Rule was meant to clear up some of the confusion among providers regarding such...more

King & Spalding

60-Day Overpayment FCA Enforcement Action Results in $2.95 Million Settlement

King & Spalding on

On August 23, 2016, a New York hospital system settled False Claims Act (FCA) allegations that it violated the 60-day overpayment rule by improperly retaining Medicaid overpayments. The whistleblower alleged that three of the...more

Sheppard Mullin Richter & Hampton LLP

The Overpayment Rule and the Implied False Claims Theory: “What You Don’t Know Can Still Hurt You”

Sheppard Mullin Richter & Hampton LLP on

In 2010, the Affordable Care Act (“ACA”) enacted new rules governing overpayments made by the Medicare and Medicaid programs. Under these rules, providers have 60 days from the date that the overpayment has been identified to...more

Parker Poe Adams & Bernstein LLP

CMS Finalizes Rule on Reporting and Returning Medicare Overpayments

Parker Poe Adams & Bernstein LLP on

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

Womble Bond Dickinson

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

Womble Bond Dickinson on

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

Stinson LLP

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

Stinson LLP 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

Williams Mullen

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

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

McCarter & English, LLP

Health Law Insights Newsletter - Issue 7 - March 2016

McCarter & English, LLP on

McCarter & English, LLP’s Health Care Group presents Issue 7 of the Health Law Insights, which discusses the latest legal issues in the health care industry. NATIONAL - Providers’ Obligation to Report Medicare...more

Holland & Knight LLP

CMS Implements Final Rule on Medicare Parts A and B Overpayments

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

Pullman & Comley - Connecticut Health Law

Final Rule Clarifies Requirements for Reporting and Returning Medicare Overpayments

Pullman & Comley - Connecticut Health Law on

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

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

Manatt, Phelps & Phillips, LLP

Health Update - February 2016

Manatt, Phelps & Phillips, LLP on

Better Late Than Never: CMS Provides Much-Needed Clarity on the 60-Day Overpayment Refund Requirements - On February 12, 2016, the Centers for Medicare & Medicaid Services (CMS) issued the long-awaited final rule (Final...more

Latham & Watkins LLP

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

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

54 Results
 / 
View per page
Page: of 3
Next »

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
Sign up Log in
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide