Nursing home provider fails in legal bid against 'extrapolation method' in determining Medicare overpaymentsFebruary 18, 2014
A government contractor can calculate how much money a provider owes for Medicare overpayments by doing a limited audit and then extrapolating from those findings, a federal appeals court recently affirmed.
Medicare payments to skilled nursing facilities should be cut 4% in 2014 and then steadily reduced in subsequent years, the Medicare Payment Advisory Commission said in a March 15 report to Congress. Rates should be decreased to achieve $10 billion in savings by 2018, the group said.
The Centers for Medicare & Medicaid Services recently issued a proposed rule addressing how it will implement the 60-day deadline for returning overpayments made to federal health programs. If fully adopted, the rule would significantly expand the liability of healthcare providers and suppliers under the federal False Claims Act.
First, it was the U.S. Supreme Court's turn to leave providers in suspense. Now, it's a group of decision-makers without robes who have operators holding their breath.
Medicaid Integrity Contractors failed to find overpayments in the majority of their audits for the first half of 2010, leading the Office of Inspector General to recommend that the Centers for Medicare & Medicaid Services revise its audit process.