Today, after the federal government announced it recovered roughly $4.1 billion in taxpayer money in 2011 from healthcare fraud prevention efforts, CMS proposed a rule that establishes deadlines for reporting and returning overpayments.
In the proposed rule (pdf) — which is part of the Patient Protection and Affordable Care Act — hospitals, physicians and other healthcare providers that receive Medicare funds must report and return self-identified overpayments within 60 days of when the overpayments were identified or when any corresponding cost report is due — whichever is later.
Previously, hospitals and other providers did not face an explicit deadline for returning the overpayment, but now any failure to report and return the incorrect payment within the 60-day timeframe could be considered a violation of the False Claims Act. Additionally, providers could face civil monetary penalties or exclusion from other federal healthcare programs if the deadline is not met.
Additionally, there would be a 10-year lookback period for Medicare overpayments. Currently, the lookback period is three to four years, and CMS estimates the extended lookback period could add $58 million in reporting expenses each year for 125,000 healthcare providers.
Public comments will be accepted through April 16.
In the proposed rule (pdf) — which is part of the Patient Protection and Affordable Care Act — hospitals, physicians and other healthcare providers that receive Medicare funds must report and return self-identified overpayments within 60 days of when the overpayments were identified or when any corresponding cost report is due — whichever is later.
Previously, hospitals and other providers did not face an explicit deadline for returning the overpayment, but now any failure to report and return the incorrect payment within the 60-day timeframe could be considered a violation of the False Claims Act. Additionally, providers could face civil monetary penalties or exclusion from other federal healthcare programs if the deadline is not met.
Additionally, there would be a 10-year lookback period for Medicare overpayments. Currently, the lookback period is three to four years, and CMS estimates the extended lookback period could add $58 million in reporting expenses each year for 125,000 healthcare providers.
Public comments will be accepted through April 16.
Related Articles on Hospital Overpayments:
Medicare RACs Collected $1.27B in Overpayments Since 2009
OIG Reviews Self-Disclosure Protocol for Healthcare Fraud
Medicare Overpays 50 Teaching Hospitals for Double-Counted Residents