CMS Revises Medicare Overpayment Rule

Posted on: February 17, 2016 by Javier iSure

More provisions set by the Affordable Care Act are being implemented in healthcare facilities nationwide. As CMS revised the Medicare Overpayment Rule to 60 days, healthcare providers and suppliers are now obligated to pay back any excess of funds within 60 days of identifying the overpayment. In order to protect their operations and manage this new regulation, a sound Miami Healthcare Industry Insurance package is required for these professionals.

Three years after publishing a notice of public rulemaking requiring hospitals to report Medicare overpayments to CMS, the agency finalized a rule that makes significant concessions to providers, but still requires a six-year lookback period, says HealthLeaders Media.

While the original rule, first proposed on February 16, 2012, brought this requirement to attention, it is only now that the law has been finalized. Further, the CMS also identified what constitutes “identification” of an overpayment, the mechanics of returning an overpayment, and the period of time subject to repayment, says Reed Smith.

The new rule requires that hospitals and healthcare providers return the overpayments within 60 days of identifying the misstep, which also includes any corresponding cost reports that might be due.

In addition, the lookback period, which originally spanned 10 years, has now been reduced to six. While still a lengthy amount of time to be able to review administrative processes, it is not as burdensome.

At iSure Brokers, we specialize in protecting the healthcare industry. We will evaluate your risks and needs and provide a tailored solution that best fits your practice’s exposures. For more information about our products, contact our experts today at (855) 381-6123.

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