article thumbnail

SCOTUS rejects UnitedHealth appeal of Medicare Advantage overpayment rule

Healthcare Dive

The justices declined to take up the case, leaving intact a lower court ruling that backed the 2014 CMS regulation requiring swift return of overpayments.

article thumbnail

CMS Proposes to Amend Overpayment Rule, Remove Potential Overpayment and False Claims Act Liability for Mere Negligence

Healthcare Law Blog

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”). reckless disregard or deliberate ignorance of a potential overpayment). UnitedHealthcare Litigation. The Proposed Rule.

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Retrieving Billions in Overpayments by CMS

Healthcare IT Today

Challenges of Investigating Overpayments Undeserved payments are needles lurking in the haystack of 135 million Americans enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). How can such overpayments be uncovered? public in overpayments. But the needles pile up fast.

article thumbnail

Healthcare Compliance Risks with Urine Drug Testing Overpayments 

YouCompli

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.

article thumbnail

Feds sue Cigna over alleged Medicare Advantage overpayments linked to home assessments

Fierce Healthcare

Feds sue Cigna over alleged Medicare Advantage overpayments linked to home assessments. Mon, 10/17/2022 - 15:46.

article thumbnail

Understanding Basics of Medicare Overpayment

Medisys Compliance

What is Medicare Overpayment? An overpayment is a payment made to a provider exceeding amounts due and payable according to existing laws and regulations. Identified overpayments are debts owed to the federal government. Laws and regulations require CMS recover overpayments. Medicare Overpayment Collection Process.

article thumbnail

OIG calls on CMS to do more to collect Medicare overpayments from hospitals

Fierce Healthcare

OIG calls on CMS to do more to collect Medicare overpayments from hospitals. Fri, 10/28/2022 - 15:03.