Via: Final Rule Clarifies Reporting and Returning Medicare Overpayments

legal issueSection 6402 (a) of the Patient Protection and Affordable Care Act (PPACA), enacted March 23, 2010, established a new Section 1128J(d) of the Social Security Act (SSA)1 requiring a person who receives an overpayment to report and return the overpayment to the Secretary of Health and Human Services (HHS), the state, an intermediary, a carrier, or a contractor (as appropriate). The statute requires overpayments to be reported and returned by the later of (A) 60 days after the date on which the overpayment was identified; or (B) the date any corresponding cost report is due, if applicable. A proposed rule addressing this statutory requirement was published on February 16, 2012 (hereafter, Proposed Rule).2 Nearly four years later (and after considering approximately 200 timely-filed correspondences containing comments to the Proposed Rule), on February 12, 2016 the Centers for Medicare & Medicaid Services (CMS) published its Final Rule related to Medicare Part A and Part B providers’ and suppliers’ obligations to report and return overpayments (hereafter, Final Rule).3 Failure to report and return an identified overpayment under the Final Rule could be actionable under the False Claims Act (FCA). The provisions of the Final Rule became effective March 14, 2016. Key provisions of the Final Rule are summarized below.

via: Reporting and Returning Medicare Overpayments: Long Awaited Final Rule Provides Clarification

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