Final revisions to fraud rules expected by spring

Revisions to three healthcare fraud and abuse rules, including one that would increase the Office of Inspector General's ability to impose civil monetary penalties, are expected to be finalized by spring 2016, according to a new federal report.

A revision to the government's authority over enforcing CMPs is expected to be released as a final rule in May 2016, White House Office of Management and Budget's fall rule agenda shows. The final rule will allow the OIG to impose the penalties for failing to provide documents to the agency in a timely manner, making false statements or omissions on enrollment applications and failing to return overpayments, among other reasons. The revisions in the rule were included as provisions in the Affordable Care Act.

A final rule that would increase the OIG's ability to exclude providers from participating in government healthcare programs is also expected in May. The proposed rule would allow the OIG to exclude entities or individuals convicted of obstructing an audit, failing to give payment information to Medicare or state-run health programs and making false claims on provider applications.

The OMB's fall rule list also shows a June due date for a final rule that would form a new anti-kickback statute covering some Medicare Part D activities.

A final version of the 60-day overpayments rule will be released in February, according to the agenda. The rule would require providers to return overpayments and notify the agency the payment was returned to within 60 days of first identifying the overpayment.