CMS Proposes New Guidelines for Reporting and Refunding Medicare Overpayments
8/31/2024
On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the 2025 Medicare Physician Fee Schedule Proposed Rule which, among other things, proposes amendments to deadlines for reporting and returning Medicare Part A and Part B overpayments.
Specifically, CMS is proposing more lenient deadlines for reporting and returning overpayments, giving providers more time to investigate and calculate overpayments. The Proposed Rule, if adopted, would suspend the 60-day period for reporting an overpayment if an overpayment is identified but a good-faith investigation to uncover related overpayments has not been completed. This pause would last until the earlier of either (i) the completion of the investigation and calculation of related overpayments or (ii) 180 days from the initial identification of the overpayment. The pause would also apply if a provider makes a submission to the Office of the Inspector General (OIG) Self-Disclosure Protocol, the CMS Voluntary Self-Referral Disclosure Protocol, or requests an extended repayment schedule. Once the suspension ends, the requirement to report and return the overpayment would occur within either (i) 60 days after concluding the investigation and calculating the overpayment or (ii) 180 days from the initial discovery of the overpayment.
John D. Fanburg
Managing Member
Healthcare Law, Cannabis Industry
973.403.3107 · 973.618.5507 Fax
jfanburg@bracheichler.com
Related Practices: Healthcare Law
Related Attorney: John D. Fanburg, Edward J. Yun, Vanessa Coleman
Related Industry: Healthcare
