Education Is Key to Reporting and Returning Overpayments

Organizations that fail to report overpayments within 60 days can be liable under the False Claims Act and may be subject to civil/criminal liabilities.

In just FY 2015 alone, the justice department recovered $3.5 billion from False Claims Act cases, an overwhelming motivation for healthcare organizations to stay ahead of the compliance curve to protect themselves from financial ruin and a destroyed reputation.

However, even when it seems like your compliance program is running smoothly, it's still possible for mistakes to be made. What if, during a routine audit, you come across a long running error in billing and coding processes and discover years of overpayment from Medicare? Are you prepared to act fast?

Education is key when it comes to Reporting and Returning Overpayments. On Feb. 12, 2016, after four years (that has felt like four decades), the CMS published the final rule on Reporting and Returning Overpayments (aka 60-day overpayment rule), which goes into effect March 14, 2016. The final rule provides clarifying answers to complex questions we've been faced with since the Affordable Care Act in March of 2010 required return of overpayments within 60 days.

The final rule covers: When the clock starts ticking on the 60-day rule to return all overpayments, how far back you need to go for return payments, your obligation to investigate suspected overpayments, and when exactly the False Claims Act is implicated, and more.

Watch our free webinar on-demand, "Overpayment and Reporting Best Practices", to make sure your compliance program is always prepared. Just click the button below: