News & Analysis as of

Overpayment

Dickinson Wright

Recovering Retirement Plan Overpayments: Process is Key

Dickinson Wright on

A qualified retirement plan paying more in distributions than a participant is entitled to occurs frequently. Common reasons for overpayments include miscalculation of benefits due to systemic error, the plan sponsor being...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

King & Spalding

HHS Releases New Frequently Asked Questions Regarding CARES Act Provider Relief Funds - April 2021

King & Spalding on

Last week, HHS released eleven modified Frequently Asked Questions (FAQs) regarding payments distributed to providers via the CARES Act Provider Relief Fund. The FAQs cover audits and overpayments, sharing funds with...more

Dentons

Refund of interest on VAT settled under the intra-Community acquisition of goods and import of services regime

Dentons on

Taxpayers who have been making intra-Community acquisitions of goods and import services after January 1, 2017, who settled VAT on this account after the expiry of the 3-month period provided for in Polish regulations and...more

Health Care Compliance Association (HCCA)

Provider Wins $2M Appeal at ALJ Over Modifier 25, Random Sample

Report on Medicare Compliance 30, no. 11 (March 22, 2021) - A cancer center has won its appeal of $2 million in Medicare claim denials in a case about modifier 25 and the extrapolation of an overpayment. Problems with the...more

Wiley Rein LLP

Tenth Circuit Finds That Actions by the FCC to Collect USF Overpayments Are Not Subject to Any Statute of Limitations

Wiley Rein LLP on

A recent decision by the U.S. Court of Appeals for the Tenth Circuit addressed the applicable statute of limitations that applies to efforts by the Federal Communications Commission (FCC or Commission) to recover the...more

Bass, Berry & Sims PLC

Recent FCA Cases Emphasize the Importance of Diligently Addressing Potential Overpayments

Bass, Berry & Sims PLC on

A common feature of False Claims Act (FCA) litigation is the pursuit of liability under the FCA’s so-called “reverse” false claims provision, 31 U.S.C. § 3729(a)(1)(G).  Reverse false claims liability applies when a person or...more

Nexsen Pruet, PLLC

How to Avoid Healthcare Overpayments: Top Five Mistakes Providers Make and the Real Cost of Non-Compliance

Nexsen Pruet, PLLC on

Over the last 25 years, I have assisted healthcare providers as a lawyer and as a compliance professional with handling routine overpayment matters, internal and external billing investigations, and fraud and abuse matters. ...more

Health Care Compliance Association (HCCA)

CMS offers correct billing tips for nonphysician outpatient services provided before or during inpatient stays

Compliance Today (March 2021) - The Centers for Medicare & Medicaid Services (CMS) has provided the following compliance notice: “In a recent report, the Office of Inspector General (OIG) determined that Medicare made...more

Husch Blackwell LLP

Hospice Audit Series: The Latest Developments and Strategies for Success in the Ever-changing Audit Landscape

Husch Blackwell LLP on

Hospice Audits Series Audits are a fact of life for hospices—it’s not a matter of “if” a hospice will be audited, but “when.” The alphabet soup of audits has expanded, from UPICs to SMRCs, CPIs, TPEs and more. With the...more

Horton Law PLLC

[Webinar] New York Wage Deductions: What May Companies Withhold from Workers’ Pay? - February 25th, 1:00 pm ET

Horton Law PLLC on

New York has extensive limits on what private (non-government) employers may deduct or withhold from employees’ compensation. Violations of these restrictions essentially constitute “wage theft” under the NYS Labor Law. ...more

Cozen O'Connor

FTC Under New Management | First Assertion Of The BOTS Act | Ash Cleanup Costs Redistributed

Cozen O'Connor on

Breaking News- New Leadership at the FTC- •President Joseph R. Biden designated Federal Trade Commission (“FTC”) Commissioner Rebecca Kelly Slaughter as Acting Chair of the FTC . •As Commissioner, Chairwoman...more

K&L Gates LLP

Qui Tam Quarterly - COVID-19 and the Big-Data Revolution of Health Care False Claims Act Litigation

K&L Gates LLP on

This edition of Qui Tam Quarterly focuses on: - the history of big data in health care FCA investigations and litigation; - how the government has increased its ability to gather health care claims data and use it to...more

Hodgson Russ LLP

Circuit Court Holds Plan Entitled to Recoupment of Overpayment

Hodgson Russ LLP on

In 2016, the Supreme Court held, in Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan, that Section 502(a)(3) of the Employee Retirement Income Security Act allows a plan to recover an...more

Groom Law Group, Chartered

Ford Motor Case Highlights ERISA Issues With Recovery of Overpayments

The Sixth Circuit’s recent decision in Zirbel v. Ford Motor Company (2020 BL 445882, Nov. 16, 2020) provides a useful illustration of the key issues that arise when ERISA plans seek to recover money from participants or...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 43. News Briefs: December 2020

Report on Medicare Compliance 29, no. 43 (December 7, 2020) - In a new provider compliance audit, the HHS Office of Inspector General (OIG) said The Palace at Home, a for-profit home health care agency (HHA) in Miami,...more

King & Spalding

OIG Announces Resumption of Medicare Inpatient Short Stay Audits

King & Spalding on

In its November 2020 Work Plan update, OIG announced it will begin auditing short stay inpatient hospital claims under the Two Midnight Rule, and when appropriate, recommend overpayment collections. OIG does not specify the...more

Health Care Compliance Association (HCCA)

Hospitals Were Overpaid $33M Over Device Credits; Policy May Change

Report on Medicare Compliance 29, no. 42 (November 23, 2020) - Medicare administrative contractors (MACs) will be coming to 911 hospitals for overpayments caused by unreported manufacturer credits for recalled or...more

Faegre Drinker Biddle & Reath LLP

Annuity Overpayments: What You Need to Know

Each year, insurers pay out millions of dollars on annuities that are not owed. This not only results in financial loss, but also leads to over-inflated reserves. The problem persists because it is increasingly difficult for...more

Arnall Golden Gregory LLP

OIG Weighs-In on the Review of Extrapolated Overpayments in the Medicare Appeals Process

The financial stakes are often very high for providers when statistical sampling and extrapolation is used to calculate an alleged Medicare overpayment. In post-payment audits involving extrapolation, an actual claims denial...more

Health Care Compliance Association (HCCA)

In Provider Compliance Audit, OIG Said HHA Was Overpaid $5.9M

Report on Medicare Compliance 29, no. 30 (August 24, 2020) - Mission Home Health of San Diego Inc. was overpaid $61,718 in 2015 and 2016, which was extrapolated to $5.9 million, according to the latest Medicare home health...more

McGlinchey Stafford

IRS Guidance on Recapturing Excess Employment Tax Credits

McGlinchey Stafford on

The Internal Revenue Service has issued a temporary regulation and a proposed regulation (pursuant to authority granted in the Families First Act and the CARES Act) to allow the agency to administratively recapture any excess...more

Dickinson Wright

Interest on Overpayments of 2019 Income Taxes

Dickinson Wright on

The IRS recently placed a notice on its website indicating that interest on overpayments of 2019 income taxes reflected on individual tax returns (Form 1040) will run from April 15, 2020 until the IRS pays the tax refund...more

Health Care Compliance Association (HCCA)

DAB Affirms OIG's $1.32M Penalty on Provider for Breaching CIA

Report on Medicare Compliance 29, no. 23 (June 22, 2020): The HHS Departmental Appeals Board (DAB) has upheld the largest stipulated penalty imposed by the HHS Office of Inspector General (OIG) in years. OIG fined...more

Winstead PC

Companies Should Know When Their Customers Die: Court Rendered Judgment For An Estate Who Was Sued By An Annuity Company For...

Winstead PC on

In In re Estate of Scott, an annuity company sued a customer’s estate for not reporting the death of his wife, which resulted in him receiving larger monthly payments after her death than he was entitled to under the...more

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