Tag Archives: 60-Day Refund Rule

The Who, What, and When for the CMS Final 60-Day Rule

Four years after the issuance of the Proposed Rule and six years after the authorizing statute, CMS has published the much-awaited Final Rule regarding reporting and returning of Medicare Part A and B overpayments (the “Final Rule”). 81 Fed. Reg. 7654-7684 (Feb. 12, 2016).  Since the inception of section 6402(a) of the Affordable Care Act … Continue reading this entry

Fasten Your Seat Belts: District Court Says “Failure to Act Quickly Enough” May Violate 60-Day Refund Rule

A New York Federal District Court issued an Opinion and Order, on August 3, 2015, in a closely-watched False Claims Act (FCA) case, Kane v. Healthfirst, Inc. The Court refused to dismiss the whistleblower complaint in which both the federal government and the State of New York have intervened. As important to this discussion, the … Continue reading this entry

CMS Delays Publication of Final Rule Regarding Reporting and Returning of Medicare Overpayments

One of the most challenging compliance changes brought about by the Affordable Care Act (ACA) is the provision mandating the reporting and refunding of Medicare and Medicaid overpayments within 60 days of the date they are identified, or the date that the corresponding cost report is due, if applicable. See ACA Section 6402(a); Section 1128J(d) … Continue reading this entry

Government's Health Care Fraud "Cash Cow" Keeps Mooing

Recent Decision Underscores Need for Involvement of Counsel in Internal Investigations
In a conversation with Lee Pacchia from Mimesis Law, Foley & Lardner Partner, Lisa Noller, discusses the Government’s approach to health care fraud prosecutions and what companies can expect in 2015. Since 2007, the Department of Justice (DOJ) has increased its affirmative civil and criminal enforcement priorities. Rather than relying on whistleblowers to come forward and … Continue reading this entry