2014 Hospice Proposed Rule Released - Posted: May 20, 2013
CMS seeks public comment on defining QIO service areas - Posted: May 13, 2013
CMS issues proposed rule to increase rewards for reporting of fraud and abuse - Posted: May 06, 2013
Changes to OASIS are coming: OASIS-C1 to be proposed - Posted: April 29, 2013
Caring for yourself: Safe patient handling - Posted: April 22, 2013
Understanding adverse drug events - Posted: April 15, 2013
MRSA in homecare: What is MRSA and how can it be prevented? - Posted: April 08, 2013
Writing goals at your agency: Three common mistakes and how to fix them - Posted: April 01, 2013
MedPAC Issues Annual Report to Congress - Posted: March 25, 2013
Nutrition plans for patients with swallowing disorders - Posted: March 18, 2013
by Beacon Health Staff
March 05, 2012
|Proposed Rule Issued to Address Overpayments
for Medicare and Medicaid Services (CMS) has proposed that providers and
suppliers must report and return self-identified overpayments either within 60
days of the incorrect payment being identified or on the date when a
corresponding cost report is due, whichever is later. This proposed rule was
published in the Federal
on February 16, 2012.
Coming as a result of the Affordable
Care Act, this is one in a series of steps Medicare is taking to protect
taxpayer dollars and efforts to prevent overpayments from occurring.
These efforts include letting private auditors work on behalf of Medicare to
identify wasteful spending before it happens by expanding the use of Recovery
Audit Contractors, testing changes to outdated hospital billing systems to help
prevent over-billing, and changing processes for approving payments for medical
equipment with high error rates.
overpayment means any funds that a person receives or retains under Medicare to
which the person is not entitled.
Examples of overpayments in Medicare
submission of the same service or claim
to the incorrect payee
for excluded or medically-unnecessary services
for non-covered service
There will be a specific timeframe
by which overpayments must be reported and returned. Any failure to
report and return the overpayment within the applicable time frame could be a
violation of the False Claims Act
. Providers also could be subject
to civil monetary penalties or excluded from participating in federal
healthcare programs for failure to report and return an overpayment.
This proposed rule was announced on
the same day that the announcement was made that the Health Care Fraud and
Abuse Control Program had recovered $4.1 billion in 2011 from anti-fraud
efforts, while the Department of Justice opened 1,110 new criminal health care
fraud investigations involving 2,561 potential defendants.
© 2012 Beacon Health, a division of HCPro, Inc. All rights reserved.
There are 1000s of articles like this one in the Beacon Health Knowledgebase! Click here to learn more.