Providers would be overburdened by Medicare overpayment rule, expert notes

Share this article:

A proposed rule that would require Medicare providers to return overpayments within 60 days of detection could significantly increase administrative time and costs, an expert says.

The Centers for Medicare & Medicaid Services in February proposed a rule mandating that providers report and return overpayments of Medicare Part A and Part B. Medicare Part A pays for short-term stays in skilled nursing and rehabilitation facilities.

But the rule is not consistent with providers' expectations, attorney Robert L. Roth said in a Bureau of National Affairs webinar this week. He said the regulation contains a 10-year look-back period that CMS picked because it's on the outer limit of the federal False Claims Act statute of limitations.

“The 10-year standard inappropriately links simple payment errors with the FCA liability standard, which is intended for intentional fraud,” Roth said in the webinar.

Under the rule, providers must specify to CMS why the overpayment went through, within 60 days of identifying it. Failing to do so beyond the 60-day limit would create a FCA obligation and incur a $10,000 fine for each overpayment.

Share this article:

More in News

Bill addressing admission status receives praise

A bill that would require hospitals to give patients a formal notice of their admission status has received strong support from healthcare associations.

Increased 'bed taxes' on nursing facilities warrant stricter federal oversight, report states

States have been increasingly taxing skilled nursing facilities and other healthcare providers to fund Medicaid in recent years, and federal authorities should look more closely at this trend, according to a government report released Tuesday.

Last chance: Tech Awards deadline arrives

Last chance: Tech Awards deadline arrives

There are hours left for innovative long-term care providers to enter the third annual McKnight's Excellence in Technology Awards. Submissions will be accepted until the stroke of midnight tonight.