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2024 Final Rule: CMS Announces More Changes to Medicare Advantage but Declines to Reform the “60 Day Rule”

Health Care Law Brief

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.”

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Compliance is Everybody’s Business: Clinical, Revenue Cycle, IT, Sales and Marketing

YouCompli

Here, any overpayment from a governmental payer source must be returned within 60 days of its identification. IT often recommends the adoption of certain tools and technologies that impact your electronic medical records. Those issues can help with early identification of localized and more systemic issues.

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Part 3: Audit Documentation to Avoid Potential Appeal Consequences

AIHC

Providers may take documentation “short cuts” or feel overwhelmed with implementation of a new EMR (electronic medical record) system and clone or make documentation errors. If the payer, such as Medicare, performs an extrapolation, reducing each overpayment dollar through appeal can mean thousands less to pay back.

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Health Provider News – October 7, 2022

Hall Render

Judge orders Anthem to face lawsuit over alleged Medicare overpayments. Medical groups want lawmakers to bolster safety for health care workforce. CCH about halfway through electronic medical records system install. How tight nursing home capacity is bottlenecking hospital operations.