Affordable Care Act, 60-Day Rule, Overpayment Recovery Time Limits

Apply the 60-Day Rule to Medicaid Overpayments

Ruder Ware on 5/31/2019

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

A 60-Day Overpayment Refund Rule update

Bricker Graydon LLP on 1/11/2019

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

Federal Court Overturns CMS Overpayment Rule

Roetzel & Andress on 11/12/2018

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

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

Chambliss, Bahner & Stophel, P.C. on 8/23/2017

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

Preventing Overpayments from becoming False Claims

Dickinson Wright on 6/6/2017

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

Repayment and Self Disclosure of Known Overpayments

Ruder Ware on 5/5/2017

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

2016 Health Care Year in Review

Burr & Forman on 12/12/2016

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

Health Law Pulse - September 2016

Robinson & Cole LLP on 9/7/2016

DOJ, NY AG REACH SETTLEMENT WITH HOSPITALS IN LANDMARK 60 - DAY RULE CASE - On August 24, 2016, the U.S. attorney for the Southern District of New York and the New York State attorney general announced a $2.95 million...more

60-Day Overpayment FCA Enforcement Action Results in $2.95 Million Settlement

King & Spalding on 8/30/2016

On August 23, 2016, a New York hospital system settled False Claims Act (FCA) allegations that it violated the 60-day overpayment rule by improperly retaining Medicaid overpayments. The whistleblower alleged that three of the...more

The Overpayment Rule and the Implied False Claims Theory: “What You Don’t Know Can Still Hurt You”

Sheppard Mullin Richter & Hampton LLP on 7/14/2016

In 2010, the Affordable Care Act (“ACA”) enacted new rules governing overpayments made by the Medicare and Medicaid programs. Under these rules, providers have 60 days from the date that the overpayment has been identified to...more

Center for Medicare & Medicaid Services Announces 60-Day Overpayment Rule

Stinson LLP on 4/12/2016

The Centers for Medicare & Medicaid Services (CMS) published the Reporting and Returning of Overpayments Final Rule (Final Rule) on February 12, 2016. The Final Rule implements Section 6402(a) of the Affordable Care Act,...more

CMS Implements Final Rule on Medicare Parts A and B Overpayments

Holland & Knight LLP on 3/11/2016

After more than four years since the issuance of its Proposed Rule, the Centers for Medicare & Medicaid Services (CMS) will implement its Final Rule on the reporting and return of Medicare Parts A and B overpayments,...more

CMS Issues Final Regulations to Guide Medicare Providers and Suppliers in Complying with 60-Day Mandate to Report and Return...

Cadwalader, Wickersham & Taft LLP on 2/23/2016

The Patient Protection and Affordable Care Act (“PPACA”), signed into law on March 23, 2010, included a provision (the “Report and Refund Mandate”), broadly requiring health care providers, suppliers, Part D plans and managed...more

Critical Analysis of CMS’ Final Rule Implementing the Affordable Care Act’s 60-Day "Report and Return" Overpayment Rule

Pillsbury Winthrop Shaw Pittman LLP on 2/19/2016

On February 12, 2016, the Centers for Medicare & Medicaid Services (CMS) published a long-awaited final rule (Final Rule) implementing the Affordable Care Act’s (ACA’s) statutory requirement that certain overpayments be...more

CMS Finalizes 60-Day Rule Overpayment Regulations

Robinson & Cole LLP on 2/19/2016

On February 12, 2016, the Centers for Medicare & Medicaid Services (CMS) released a final rule (Final Rule) interpreting the application of Section 1128J(d) of the Social Security Act (the 60-Day Rule) to over payments...more

CMS Releases Highly Anticipated Final Rule on Returning Overpayments

Saul Ewing Arnstein & Lehr LLP on 2/17/2016

In the February 12, 2016 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published a final rule (Final Rule) with respect to reporting and returning overpayments by Medicare Part A and Part B providers to...more

New CMS rule clarifies when 60-day overpayment clock starts ticking

Akerman LLP - Health Law Rx on 2/16/2016

Four years after publication of its proposed rule related to reporting and returning overpayments within 60 days, CMS has issued a final rule that responds to comments and provides greater clarity. The published rule is under...more

60-Day Overpayment Final Rule Eases Obligations for Health Care Providers But Still Reinforces Need for Vigilance

Bryan Cave Leighton Paisner on 2/12/2016

On Feb. 11, the Centers for Medicare & Medicaid Services (CMS) published a final rule relating to the overpayment providers receive from federally funded health care programs. While the rule eases some of the burden for...more

Breaking News: 60-Day Overpayment Rule Finalized

BakerHostetler on 2/12/2016

The Centers for Medicare and Medicaid Services (CMS) released its final rule implementing Section 6402(a) of the Affordable Care Act that requires Medicare providers and suppliers to report and return overpayments within 60...more

Identifying Overpayments Under the ACA’s 60-Day Rule Creates Additional Uncertainty in Determining False Claims Act Liability

Akerman LLP - Health Law Rx on 11/6/2015

Under the Affordable Care Act (ACA), healthcare providers that receive an overpayment from Medicare or Medicaid are required to report and return the overpayment to the government within 60 days after the date on which the...more

Patient Protection and Affordable Care Act (PPACA) › 60-Day Rule › Overpayment Recovery Time Limits