Hall Render

JANUARY 12, 2023

On December 27, 2022, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule that could potentially have a significant impact on enrollees’ obligations under the “60-day” overpayment rule. In fact, claims reviews to quantify an overpayment is a time-consuming effort and the six-month period is necessary.

Overpayments 40

Overpayments Overpayment Medicare Medicare 40

Health Care Law Brief

JUNE 26, 2022

With this denial, the Overpayment Rule remains in full force and effect, and UnitedHealthcare, among other MA plans, must comply or potentially face False Claims Act (FCA) liability. The Overpayment Rule. The Overpayment Rule, set forth at 42 U.S.C. 29844, 29921 (May 23, 2014).

Overpayments 52

Overpayments Overpayment Medicare Medicare 52

HIT Consultant

MARCH 20, 2024

The HHS Office of Inspector General (OIG) recently reported that, from October 2014 through December 2016 , 153 audit reports were issued containing 193 overpayment recoveries totaling $648 million, largely due to errors in medical documentation. million (net) and $4.7 billion from 2023 through 2032, including extrapolation effects.

Overpayments 52

Overpayments Overpayment Medicare Medicare 52

Health Care Law Brief

APRIL 3, 2023

We summarize the key factors and adjustments to the overall expected average rate increase of 3.32% (which is about $13.8 The 2024 Risk Model uses diagnoses from 2018 and costs reflected from 2019 as opposed to the 2020 Risk Model that used 2014 diagnoses and 2015 costs. See 88 Fed. 6643 (Feb.

Medicare 52

Medicare Medicare Overpayments Overpayment 52