Ensuring Compliance With CMS 60-Day Overpayment Rule

Law360, New York (August 15, 2016, 11:51 AM EDT) -- Linda A. Baumann

Hillary M. Stemple Everyone working in the health care industry today knows how often overpayments can occur. Some are isolated instances, while others may involve hundreds of claims and are not detected until years after they first occurred. Moreover, overpayments often result from mistake, inadvertence or perhaps negligence, rather than intentional fraud. Nevertheless, it is clear under the Affordable Care Act that any provider who receives an identified overpayment is under a direct legal mandate to return it.

Specifically, the ACA requires all Medicare and Medicaid overpayments to be reported and returned by the later of (1) 60...

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