YouCompli

FEBRUARY 4, 2025

Even if an entity makes an isolated billing error, that entity still has an obligation to repay the overpayment to avoid False Claims Act liability.

Nurses 52

Nurses Overpayments Overpayment Compliance 52

Compliancy Group

FEBRUARY 12, 2025

The ICPG highlights risks associated with the SNF Prospective Payment System (PPS), value-based payment models, and Medicare Advantage plans. As the ICP notes, even a single, isolated billing error resulting in an overpayment must be repaid to avoid potential False Claims Act (FCA) liability.

Nurses 52

Nurses Compliance Medicare Medicare 52

YouCompli

FEBRUARY 22, 2023

It is “prospective” because hospitals and other providers know ahead of time what they will be reimbursed. This is why Medicare publishes its rules on their Inpatient Prospective Payment System (IPPS) or its Outpatient Prospective Payment System (OPPS). If they were not, the hospital must return the funds.

Compliance 52

Compliance US Department of Health and Human Services Overpayments Overpayment 52

Healthcare IT Today

FEBRUARY 2, 2024

Payers battle administrative overload caused by reconciling inaccurate payments and reprocessing claims to pay the accurate reimbursement amount. This reactive model leads to only ~70% of identified overpayments being recovered and/or corrected. In adopting pre-payment systems, the synergy between payers and providers is paramount.

Payment Systems 73

Payment Systems Overpayments Overpayment Medical Billing 73

Hall Render

NOVEMBER 25, 2024

The Nursing Facility ICPG provides that, even if an entity makes an isolated billing error, the entity still has an obligation to repay the overpayment to the government to avoid False Claims Act liability, as explained in the GCPG. It is intended only to assist nursing facilities in evaluating and mitigating their own particular risk areas.

Nurses 40

Nurses Compliance Compliance Officers Medicare 40

Hall Render

MARCH 15, 2024

NATIONAL 3 things to expect from the pharmaceutical supply chain in 2024 Absence of AI hospital rules worries nurses American Academy of Dermatology votes to keep its diversity policies after anti-DEI proposal Are digital health partnerships replacing M&A? From -6.8%

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40