Sheehan warns doctors about new Medicaid overpayment policies

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Healthcare reform law provisions pertaining to reporting and returning overpayments present a critical Medicaid challenge facing physicians next year, New York State Medicaid Inspector General Jim Sheehan said this week.

A section of the Patient Protection and Affordable Care Act allows providers a maximum of 60 days after an overpayment to report the error, return the correct amount and provide an explanation for the overpayment in writing, he said, according to the Bureau of National Affairs. Sheehan spoke to the Health Care Compliance Association's Physician Practice Compliance Conference Tuesday. After 60 days the payment is considered a false claim, which triggers penalties and activation of whistleblower hotline under the False Claims Act, he said.

Also under the bill, any physician terminated by a state after Jan. 1, 2011, must be terminated by every other state. If the Centers for Medicare & Medicaid Services revokes a provider's enrollment, every state must do likewise, he said.