Healthcare Law Blog
DECEMBER 27, 2022
The Centers for Medicare and Medicaid Services (“CMS”) has issued a proposed rule which would amend the existing regulations for reporting and returning identified overpayments (the “Proposed Rule”). UnitedHealthcare challenged the current Overpayment Rule in litigation. [1] UnitedHealthcare Litigation. The Proposed Rule.
YouCompli
MARCH 22, 2023
There has been significant enforcement over the last couple years relating to overpayments for UDT. The overpayment rate for definitive drug testing for 22 or more drug classes was over 71%. Review at-risk payments made to at-risk providers during and after the OIG’s audit period and recover any overpayments.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
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.
Healthcare Law Blog
AUGUST 25, 2023
On August 21, 2023, the New York State Office of the Medicaid Inspector General (OMIG) announced updates to the Medicaid overpayment self-disclosure program, which now includes an abbreviated process for reporting and explaining overpayments that are considered routine or transactional in nature and have been already voided and adjusted.
Hall Render
FEBRUARY 14, 2023
billion in overpayments from MAOs for payment years 2011 through 2017. Further, CMS estimates that beginning with payment year 2018, it will identify approximately $479 million per audit year in overpayments to MAOs. Background RADV audits are the main tool that CMS uses to correct overpayments made to MAOs.
Healthcare Law Blog
FEBRUARY 1, 2023
Likewise CMS cited its fiduciary duty to protect taxpayer dollars from overpayments and its fiduciary responsibility to recover funds due to the Medicare Trust Funds. case number 18-5326 , which reinstated CMS’s Overpayment Rule for MA organizations. The Court of Appeals reversed and reinstated the Overpayment Rule.
Health Care Law Brief
APRIL 12, 2023
Notable Omissions from Proposed Rule CMS declined to adopt previously proposed amendments to the standard for “identified overpayments” under Medicare Parts A, B, C, and D. The Social Security Act requires “a person” who has received an overpayment to report and return the overpayment no later than 60 days after being “identified.”
Expert insights. Personalized for you.
98 
Let's personalize your content