CMS Timeframe for Reporting and Return of Overpayments
February 27, 2015 09:56 AM
Section 1128J(d)(2) of the Affordable Care Act requires that an overpayment be reported and returned by the later of:
(A) The date which is 60 days after the date on which the overpayment was identified; or
(B) The date any corresponding cost report is due, if applicable.
Section 1128J(d)(3) of the Act specifies that any overpayment retained by a person after the deadline for reporting and returning an overpayment is an obligation - as defined in 31 U.S.C. 3729(b)(3)) - for purposes of 31 U.S.C. 3729.
In the February 16, 2012 Federal Register(77 FR 9179), the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would implement the provisions of section 1128J(d) of the Act for Medicare Parts A and B providers. That proposed rule, however, has not been finalized.
Typically, proposed rules must be revised and finalized within three years of the proposal. Earlier this month, CMS published a noticein theFederal Register that extends by one year the timeline for publication of a final rule concerning policies and procedures for reporting and returning overpayments to the Medicare program for providers and suppliers of services under Parts A and B of title XVIII.
Even without a final regulation, providers of services under Parts A and B are subject to the statutory requirements found in section 1128J(d) of the Act and could face potential False Claims Act liability, Civil Monetary Penalties Law liability, and exclusion from Federal health care programs for failure to report and return an overpayment.