The CMS (Centers for Medicare and Medicaid Services) on the day of Thursday published a final rule that needs healthcare contributors to repay overpayments discovered within 6 years of the previous Medicare reimbursement, a much shorter lookback time than 1st proposed.
CMS had previous February postponed the final rule because of uncertainties over the proposed rule mandating contributors be on the hook for overpayments going back ten years. The American Hospital Association and the Federation of American Hospitals had blasted that proposal.
Under the latest final rule, contributors must also give back the overpayments either within sixty days of when the overpayment was discovered, or the due date of any cost report regarded to the payment. The rule applies to contributors receiving payment from Medicare Parts A and B.
CMS stated that the rule clarifies requirements for repayment and secures the Medicare Trust Fund from deception and inaccurate payments.
CMS also clarified what it means officially to recognize an overpayment.
"This final rule claims that an individual has recognized an overpayment when the individual has or should have, through the exercise of reasonable diligence, found that the person has gained an overpayment and quantified the amount of the overpayment," in accordance to the rule.
Under the Affordable Care Act, contributors could be charged under the False Claim Act, hit with civil fines, or be kicked out from engaging in federal reimbursement plans for failing to recognize and repay overpayments.
The final rule is also applicable to medical suppliers that acquire payments from Medicare.
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