Healthcare Law Blog

FEBRUARY 1, 2023

Statutory and Regulatory Authority : CMS cited its statutory authority to audit providers and recoup improper payments under the Medicare statute. 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. Becerra et al.,

Medicare 105

Medicare Medicare Overpayments Overpayment 105

YouCompli

FEBRUARY 22, 2023

This is why Medicare publishes its rules on their Inpatient Prospective Payment System (IPPS) or its Outpatient Prospective Payment System (OPPS). However, there are certain circumstances when Medicare, for example, will reimburse additional amounts beyond the prospective payment rate.

Compliance 52

Compliance US Department of Health and Human Services Overpayments Overpayment 52

Hall Render

JUNE 22, 2022

On Friday, June 17, 2022, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2023 Home Health Prospective Payment System Rate Update (“PPS Rule”). CMS states a temporary adjustment is necessary to offset this overpayment. That file may be accessed here.

COVID-19 40

COVID-19 Payment Systems Medicare Medicare 40