Medicare has two more years to reclaim any overpayments

HHS issues final rule on federal payment rates for new Medicaid beneficiaries

Providers will have to hold their breath a little longer after receiving Medicare payments, thanks to a little-publicized provision of recently signed fiscal cliff legislation.

The Centers for Medicare & Medicaid Services now has five years rather than three to recover non-fraudulent Medicare overpayments. 

The Office of the Inspector General recommended the change in May. 

The Department of Health and Human Services investigative arm reported that the three-year statute of limitations prevented CMS from collecting more than $332 million in overpayments that it discovered in just the 154 audit reports that it examined. Details were included in the OIG report  “Obstacles to Collection of Millions in Medicare Overpayments.”

Providers say that three years should be sufficient for recovery efforts. They also complain that auditing the additional two years will place an unreasonable burden on them. 

Some provider advocates also claimed that the process to include the measure was murky and that many lawmakers might not have even known what they were voting on.