News & Analysis as of

Final Rules Centers for Medicare & Medicaid Services (CMS) Overpayment

Proskauer - Health Care Law Brief

CMS Proposes Additional Modifications to the Overpayment Rule Relating to the Deadline for Reporting and Returning Overpayments

In the context of Medicare Advantage (“MA”) reform initiatives, we previously addressed the Centers for Medicare & Medicaid Services’ (“CMS”) December 27, 2022 proposal to amend its regulations set forth at 42 C.F.R. §...more

King & Spalding

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

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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

McDermott Will & Emery

Back to the Drawing Board: CMS Proposes Changing the Overpayment Rule’s “Identified” Definition

McDermott Will & Emery on

In December 2022, the Center for Medicare and Medicaid Services (CMS) unexpectedly issued a proposed rule that would materially change the obligations of entities participating in the Medicare program to report and return...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

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

Parker Poe Adams & Bernstein LLP

CMS Finalizes Rule on Reporting and Returning Medicare Overpayments

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 II

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

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

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

Pullman & Comley - Connecticut Health Law

Final Rule Clarifies Requirements for Reporting and Returning Medicare Overpayments

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

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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

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

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

Tucker Arensberg, P.C.

Final 60 Day Overpayment Rule

Tucker Arensberg, P.C. on

CMS has issued the final regulations to implement that section of the Affordable Care Act amending the Social Security Act to provide that retention of identified overpayment could be a false claim and be subject to both the...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

Foley & Lardner LLP

The Who, What, and When for the CMS Final 60-Day Rule

Foley & Lardner LLP on

Four years after the issuance of the Proposed Rule and six years after the authorizing statute, CMS has published the much-awaited Final Rule regarding reporting and returning of Medicare Part A and B overpayments (the “Final...more

Morgan Lewis

The 60-Day Rule Is Final: Assessing Your Organization’s Safeguards

Morgan Lewis on

Follow these tips to ensure compliance in the wake of the new 60-Day Rule. On February 12, the CMS finalized the 60-Day Overpayment Report and Refund rule (60-Day Rule) for Medicare Parts A and B. This long-awaited rule...more

King & Spalding

CMS Issues Long-Awaited 60-Day Medicare Parts A and B Overpayment Final Rule

King & Spalding on

On February 11, 2016, CMS released its much anticipated final overpayment reporting and refunding rule for Medicare Parts A and B (Final Rule). The Final Rule implements Section 6402(a) of the Affordable Care Act (ACA),...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

McDermott Will & Emery

CMS Issues Final Rule Governing the Return of Overpayments within 60 Days

McDermott Will & Emery on

On February 11, 2016, the Center for Medicare and Medicaid Services (CMS) issued the much-anticipated final rule concerning Section 6402(a) of the Affordable Care Act, the so-called "60 Day Rule". This section requires...more

Mintz - Health Care Viewpoints

The Final 60-Day Rule: the Good, the Bad, and the Ugly

As we announced on February 11, 2016, the Centers for Medicare & Medicaid Services (CMS) has finally published the long-awaited Final Rule governing the return of Medicare Part A and Part B overpayments within 60 days (the...more

Lathrop GPM

After Nearly Six Years of Uncertainty, CMS Establishes Final Standards for Reporting and Returning Medicare Overpayments

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Background On February 12, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published the long-awaited Final Rule establishing CMS’s official policy for the timely Reporting and Returning of Medicare overpayments...more

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