CMS Releases Final Rule on 60-day Medicare Overpayment Reporting Obligations

This morning, the Centers for Medicare and Medicaid Services (“CMS”) made available a copy of a final rule clarifying the obligations of providers and suppliers to report and return Medicare overpayments within 60 days after the date on which the overpayment was identified.  The final rule will be published in tomorrow’s Federal Register.

This final rule clarifies that overpayments are considered “identified” for the purposes of the 60-day rule “when the person has or should have, through the exercise of reasonable diligence, determined that the person has received an overpayment and quantified the amount of the overpayment.”  The final rule also states a limitation to the “lookback” period for overpayment, only requiring the reporting and return of overpayments if they are identified “within 6 years of the date the overpayment was received.”

We will have detailed further commentary on the this final rule in the coming days.

For more information about provider self-reporting obligations, please contact David Ross

David R. Ross is a Shareholder of the firm. Prior to joining the firm, and under former Governors Pataki and Spitzer, Mr. Ross served as the Acting Medicaid Inspector General for New York State. Prior to his service at the OMIG, Mr. Ross held several positions at the New York State Office of Alcoholism and Substance Abuse Services (OASAS), including Acting General Counsel, Deputy Counsel, and Associate Counsel.