ACA, Health Care Overpayments And The 60-Day Rule

Law360, New York (May 26, 2015, 11:40 AM EDT) -- Section 6402(a) of the Affordable Care Act amended the Social Security Act to establish the so-called 60-day rule.[1] The 60-day rule requires individual and institutional providers to report and return an overpayment of Medicare or Medicaid funds no later than: (1) 60 days from the date on which the overpayment is identified; or (2) the date any corresponding cost report is due, if applicable.[2] The 60-day rule defines "overpayment" to include any funds payable under Medicare or Medicaid to which the recipient is not entitled. A provider must report and return the overpayment to one of the following, as applicable: the secretary of the U.S. Department of Health and Human Services, a state, fiscal intermediary, carrier or contractor.[3] The provider must also provide a reason for the overpayment in writing.[4]...

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