News & Analysis as of

60-Day Rule

Fisher Phillips

Immigration Update: USCIS Ends “60-Day Rule” for Medical Exams and Vaccination Reports

Fisher Phillips on

A new policy update from USCIS will relieve pressure on applicants for immigration benefits by removing the requirement for a civil surgeon to sign a medical report within a short timeframe. Specifically, USCIS has updated...more

Robinson+Cole Health Law Diagnosis

No More Reasonable Diligence? CMS Proposes to Change Standard for Identifying Medicare Overpayments to Align with False Claims Act

On December 27, 2022, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule (Proposed Rule) which proposes certain policy and technical changes to Medicare regulations, including a notable change to the...more

McDermott Will & Emery

Back to the Drawing Board: CMS Proposes Changing the Overpayment Rule’s “Identified” Definition

McDermott Will & Emery on

In December 2022, the Center for Medicare and Medicaid Services (CMS) unexpectedly issued a proposed rule that would materially change the obligations of entities participating in the Medicare program to report and return...more

Burr & Forman

Temporary Waiver of “60 Day Rule” Signature Validity for Form I-693 Extended

Burr & Forman on

U.S. Citizenship and Immigration Services (USCIS) recently announced an extension to its waiver of the civil surgeon signature validity requirement for Form I-693. Form I-693 is the Report of Medical Examination and...more

Nelson Mullins Riley & Scarborough LLP

Internal Investigations are a MUST for Avoiding False Claims Act Liability

Many providers are not familiar with their obligations under the “60 Day Rule,” also known as Reverse False Claims liability, which can cause significant financial harm if providers fail to comply with these obligations....more

Husch Blackwell LLP

Nuts and Bolts of a Repayment Investigation: Keys to Conducting Investigations Under the 60-Day Repayment Rule

Husch Blackwell LLP on

When confronted with a complaint, allegation or event that implicates a potential Medicare overpayment, hospices have an affirmative duty under the federal 60-day repayment rule to conduct an investigation and refund any...more

Fox Rothschild LLP

Temporary Waiver of Civil Surgeon 60-day Signature Rule

Fox Rothschild LLP on

U.S. Citizenship and Immigration Services (USCIS) recently announced the temporary waiver of the requirement that the civil surgeon sign Form I-693, Report of Medical Examination and Vaccination Record, within a 60 day period...more

Health Care Compliance Association (HCCA)

Credible Information Is Heart of 60-Day Rule; OIG: Self-Disclosure Pauses the Clock

Report on Medicare Compliance 30, no. 28 (August 2, 2021) - When a hospital realized it had been billing for annual wellness visits without documentation of opioid and substance use screening, it wasn’t a heavy lift to...more

Patterson Belknap Webb & Tyler LLP

Repeal of Rule 23: the 60-Day Rule

On June 23, 2020, Chief Administrative Judge Marks approved the repeal of Rule 23 of the Commercial Division Rules. Rule 23 (known as the “60-Day Rule”) required movant’s counsel to notify the court and other parties...more

Farrell Fritz, P.C.

Three New Rule Amendments Proposed by the Commercial Division Advisory Council

Farrell Fritz, P.C. on

The Commercial Division Advisory Council (the “Advisory Council”) has proposed three new amendments to the Commercial Division Rules: (1) a proposed amendment to Rule 1, which will allow counsel to participate in court...more

K&L Gates LLP

The OIG Audits Diagnostic Sleep Studies — How Providers Should Respond

K&L Gates LLP on

Introduction - On June 7, 2019, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services (“HHS”) released a report summarizing its investigation into whether Medicare made payments to...more

Bass, Berry & Sims PLC

Medicare Advantage: Recent Developments in FCA Enforcement

The Medicare Advantage program, which allows private insurance companies to offer and administer Medicare benefits, continues to be an area of sharp scrutiny for False Claims Act (FCA) enforcement despite some significant...more

Ruder Ware

Apply the 60-Day Rule to Medicaid Overpayments

Ruder Ware on

The Affordable Care Act requires any person who has received an overpayment from certain defined government health programs to report and return the overpayment within 60 days after the overpayment is identified. If an...more

Bricker Graydon LLP

A 60-Day Overpayment Refund Rule update

Bricker Graydon LLP on

The 60-Day Overpayment Refund Rule (60-Day Rule) was enacted as Section 6402 of the Affordable Care Act (ACA) on March 23, 2010. ...more

Roetzel & Andress

Federal Court Overturns CMS Overpayment Rule

Roetzel & Andress on

A recent ruling by a federal district court could have a significant impact on how certain health insurers, specifically those providing coverage pursuant to Medicare Parts C (i.e., Medicare Advantage insurers) and D (i.e.,...more

Arnall Golden Gregory LLP

Court Nixes CMS’s Negligence Standard for Applying False Claims Act Liability for Failure to Report and Return Overpayments

In what has become widely known as the “60-day rule,” the Affordable Care Act (ACA) requires that Medicare and Medicaid overpayments be reported and returned within the later of the date which is 60 days after the date on...more

Baker Donelson

Physician Practice Penalized by DOJ for 60-Day Overpayment Rule Violation

Baker Donelson on

The Department of Justice (DOJ) imposed False Claims Act penalties against First Coast Cardiovascular Institute (FCCI) for failing to work credit balances and repay overpayments to federal health care programs. On October 13,...more

Faegre Drinker Biddle & Reath LLP

Yes, Virginia, There Is a Reverse False Claim

The False Claims Act has a scienter requirement: it makes it illegal to knowingly present a false claim to the government. So if a company innocently presents a false claim, it can’t be guilty of violating the Act, right?...more

Chambliss, Bahner & Stophel, P.C.

Reminder: Medical Providers Must Be Attentive to Credit Balances and Other Overpayments

It has now been a number of years since the enactment of Section 6402(a) of the Affordable Care Act ("ACA"), which requires among other things that any recipient of a Medicare or Medicaid overpayment report and return it...more

Dickinson Wright

Preventing Overpayments from becoming False Claims

Dickinson Wright on

Overpayments to healthcare providers receiving Medicare reimbursements are at risk of civil and criminal enforcement action if not attuned to a particular reimbursement rule and diligent in compliance with the rule’s...more

Ruder Ware

Repayment and Self Disclosure of Known Overpayments

Ruder Ware on

The 60-day repayment rule adopted as part of the Affordable Care Act is a very strong arrow in the quiver of federal enforcement agencies. Under the 60-day rule a known overpayment can become a False Claim if it is not repaid...more

Ruder Ware

Can Overpayments Create Criminal Liability?

Ruder Ware on

We hear a lot about potential liability under the False Claims Act (FCA) for the failure to repay overpayments within 60 days of discovery. Focus on the 60-day rule has taken focus away from the potential for criminal charges...more

Bass, Berry & Sims PLC

Healthcare Fraud and Abuse Review 2016

Bass, Berry & Sims PLC on

Bass, Berry & Sims is pleased to announce the release of its fifth annual Healthcare Fraud and Abuse Review 2016. The Review, compiled by the firm’s Healthcare Fraud Task Force, is an industry-leading guide to healthcare...more

Ruder Ware

ASLMS Annual Meeting Special Coverage: Legal and Compliance Issues Impacting Medical Practices Using Laser Technology

Ruder Ware on

Medical practices that routinely use laser technology are subject to some of the same legal issues as other types of practices. Use of lasers creates additional compliance issues and highlights certain compliance risk areas....more

Ruder Ware

When to Use the OIG’s Self Disclosure Protocols

Ruder Ware on

The HHS Office of Inspector General offers providers an opportunity to self-disclose certain violations in exchange for avoiding some of the more draconian penalties that may otherwise apply under applicable regulations. ...more

88 Results
 / 
View per page
Page: of 4

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide