McCarter & English, LLP’s Health Care Group presents Issue 7 of the Health Law Insights, which discusses the latest legal issues in the health care industry.

NATIONAL -

Providers’ Obligation to Report Medicare Overpayments Clarified in New Rule -

A final rule issued by the Centers for Medicare and Medicaid Services (CMS) on February 11 requires health care providers to report Medicare overpayments within 60 days of “identification” or risk liability for treble damages and crippling fines under the False Claims Act and Civil Monetary Penalties Laws. The rule implements an Affordable Care Act (ACA) requirement that practitioners, hospitals, and other Medicare participants identify and return reimbursement overpayments made in error or as a result of improper claim submissions within an abbreviated time period. The ACA and the final rule require that an overpayment be reported and returned by the later of 60 days after the date on which the overpayment was identified or the date any corresponding cost report is due, if applicable. Overpayments can result from errors on the part of Medicare contractors or providers and from receipt of payment for claims arising from violations of the Stark Law or Anti-Kickback Statute.