News & Analysis as of

Patient Protection and Affordable Care Act (PPACA) › Centers for Medicare & Medicaid Services (CMS) › Overpayment Recovery Time Limits

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 -
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

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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

Jones Day

D.C. District Court Vacates 60-Day Medicare Advantage Overpayment Rule

Jones Day on

The Situation: In 2016, several Medicare Advantage ("MA") organizations challenged a 2014 final rule promulgated by the Center for Medicare Services ("CMS") that broadly subjected MA organizations to potential liability under...more

Spilman Thomas & Battle, PLLC

The Rise of Managed Care Audits and Reimbursement Demands in the Wake of the ACA

Spilman Thomas & Battle, PLLC on

If the summer of 2017 demonstrated anything, it is that health care remains a complex and contentious industry. One of its many complications stems from the natural tension between health care providers and health care...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

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

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

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

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

Poyner Spruill LLP

Final CMS Rule on the Reporting and Returning of Medicare Overpayments is a Wake-Up Call for Physicians

Poyner Spruill LLP on

Effective March 14, 2016, a final rule published last month by the Centers for Medicare & Medicaid Services (CMS) implements the 60-day rule included in the Affordable Care Act (ACA) (31 U.S.C. § 1320a-7k(d)). ACA requires...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

Shumaker, Loop & Kendrick, LLP

Client Alert: Medicare Clarifies 60 Day Overpayment Rule

Shumaker, Loop & Kendrick, LLP on

On February 12, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published the long-awaited final rule implementing an Affordable Care Act requirement for healthcare providers and suppliers to report and return...more

Mintz - Health Care Viewpoints

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

Mintz - Health Care Viewpoints on

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...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

Cadwalader, Wickersham & Taft LLP

CMS Issues Final Regulations to Guide Medicare Providers and Suppliers in Complying with 60-Day Mandate to Report and Return...

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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

Pillsbury Winthrop Shaw Pittman LLP

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

Pillsbury Winthrop Shaw Pittman LLP on

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

Robinson & Cole LLP

CMS Finalizes 60-Day Rule Overpayment Regulations

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

Epstein Becker & Green

CMS Issues Long-Awaited Rule Regarding Reporting and Returning Overpayments

Epstein Becker & Green on

Section 6402(a) of the Affordable Care Act (“ACA”), which was enacted by Congress in 2010, requires a person who has received an overpayment to report and return the overpayment to the Secretary of Health and Human Services,...more

Saul Ewing Arnstein & Lehr LLP

CMS Releases Highly Anticipated Final Rule on Returning Overpayments

Saul Ewing Arnstein & Lehr LLP on

In the February 12, 2016 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published a final rule (Final Rule) with respect to reporting and returning overpayments by Medicare Part A and Part B providers to...more

Arnall Golden Gregory LLP

CMS Issues Final Word on 60-Day Overpayment Rule

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The Centers for Medicare & Medicaid Services (CMS) has just released the final 60-day overpayment rule (the Rule) on February 11, 2016, in what the agency describes as a continuing move targeted at rooting out fraudulent...more

Akerman LLP - Health Law Rx

New CMS rule clarifies when 60-day overpayment clock starts ticking

Akerman LLP - Health Law Rx on

Four years after publication of its proposed rule related to reporting and returning overpayments within 60 days, CMS has issued a final rule that responds to comments and provides greater clarity. The published rule is under...more

Bond Schoeneck & King PLLC

Health Law Wire: CMS Publishes Final Rule on Reporting and Returning Overpayments Within 60 Days of Identification (2/16)

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Four long years after first publishing its proposed rule implementing the 60-day overpayment report and return standard imposed by the Patient Protection and Affordable Care Act (ACA), the Centers for Medicaid and Medicare...more

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