In 2016, the Centers for Medicare and Medicaid Services (CMS) established a rule requiring Medicare overpayments to be returned and reported within 60 days of identification. That rule established that an overpayment was identified when the provider, through the exercise of reasonable diligence, determined it had received an overpayment and quantified the amount.  The failure to timely report and return an identified overpayment causes the retained overpayment to become a potential violation of the federal False Claims Act.

Effective January 1, 2025, CMS revised that rule such that an overpayment is identified when an entity or individual "knowingly" receives or retains an overpayment by having actual knowledge of the overpayment or acting in deliberate ignorance or reckless disregard of the overpayment.  Under the new rule, the 60-day clock to refund the overpayment starts as soon as an overpayment has been identified, regardless of whether it has exercised “reasonable diligence” to confirm the overpayment and quantified the amount.

This webinar will review the changes to the 60-day rule and describe the risks to health centers that fail to return and report overpayments within the time period.  In addition, this webinar will explain how the 60-day period can be suspended for 180 days by conducting a timely, good faith investigation to determine the existence of related overpayments that may arise from the same or similar cause as the initially identified overpayment.

The on-demand version of this webinar will be available for purchase after the conclusion of the live webinar. 

Please note: This webinar is offered as a complimentary product to all Health Center Compliance Training Plan subscribers. For more information on our Health Center Compliance Training plan, click here or contact us.