CMS proposes 60-day overpayment rule

Posted by KUNAL JAIN on Mar 1 2012

Fotolia_52605071_Subscription_Monthly_MThe Centers for Medicare & Medicaid Services (CMS) has released a proposed rule on a provision in the Affordable Care Act (ACA) requiring all overpayments to be reported and returned within 60 days of being identified by the practice. Practices should note that the 60-day requirement has been in effect since the ACA passed on March 23,2010.

The new proposal spells out how CMS will implement the requirement, including how the reporting process will work, proposing a 10-year “look back” period and providing some guidance on when an overpayment is considered “identified.” Specifically, CMS will consider an overpayment to be identified if a practice has actual knowledge of the existence of an overpayment or acts in reckless disregard or deliberate ignorance of an overpayment.

We have access of detailed analysis for our clients highlighting the key provisions of the proposed rule. While the rule will still need to be finalized, the requirement to report and return overpayments is still in effect and members should work diligently to resolve any overpayments they identify even before finalization. Members should continue to use the current process for returning overpayments outlined by their Medicare Administrative Contractor.
Please contact us if you need further information. at 727-771-1300 ex 7002



Topics: Medicare, CMS

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