CHA News Article

CMS Issues 60-Day Overpayment Final Rule
Topic to be covered at hospital compliance seminars beginning next week

The Centers for Medicare & Medicaid Services (CMS) has issued the attached long-awaited final rule that requires Medicare Parts A and B health care providers to report and return overpayments within 60 days of identifying the overpayment. After considering comments from CHA and other stakeholders, CMS finalized a lookback period for overpayment identification of six years, rather than the 10-year period included in the 2012 proposed rule. In addition, CMS clarifies that an overpayment has been “identified” for purposes of starting the 60-day deadline when a hospital or other entity “has or should have, through the exercise of reasonable diligence, determined that the [entity] has received an overpayment and quantified the amount of the overpayment.”

The final rule also details penalties and clarifies the process for reporting and returning an overpayment, which may include a claims adjustment, credit balance, self-reported refund or other reporting process set forth by the applicable Medicare contractor. CHA is currently reviewing the final rule and will provide members with a more detailed summary in the coming weeks.

Final Rule to be Covered at CHA Hospital Compliance Seminars
CHA’s annual Hospital Compliance Seminars will include a session explaining this important rule and its impact on hospitals. There is still time to register for the seminars scheduled for Feb. 17 in Sacramento and Feb. 23 in Long Beach. To view the full agenda or to register, visit www.calhospital.org/hospital-compliance

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