The Centers for Medicare & Medicaid Services (CMS) has published a final rule that requires Medicare Parts A and B health care providers and suppliers to report and return overpayments by the later of the date that is 60 days after the date an overpayment was identified, or the due date of any corresponding cost report, if applicable. A separate final rule was published in the May 23, 2014 Federal Register (79 FR 29844) that addresses Medicare Parts C and D overpayments.
For the full CMS announcement, visit the CMS website.
It has long been part of the law that overpayments, once identified, must be returned to the governmental organization that made the overpayment. Overpayments can result from inadvertent duplicate billing, billing administrative errors and payment from multiple insurance carriers, or other parties. The law generally has been clear when Medicare or Medicaid must be repaid (the pecking order of repayments, so to speak). Now CMS has published the Regulations making the timing and mechanism of repayments clear, and sanctions are available for non-compliance.
Marcum is available to assist in implementing the new Regulations p.r.n.