The underlying requirements to comply with the Affordable Care Act’s “60-day rule” may seem straightforward (i.e., overpayments must be refunded to Medicare within 60 days), but complying with the recent regulations is anything but. And the consequences for noncompliance are frightening:
- False Claims Act and Civil Monetary Penalties (up to treble damages).
- Fines of up to $11,000 (or more) for each improper payment you received and don’t correctly report and return.
- Government audit into the last 6 years of your claims to uncover further noncompliance.
- Exclusion from participation in Federal health care programs, including Medicare and Medicaid.
You don’t have to figure this out on your own. Healthcare attorney, Linda Baumann, Esq, can help. Linda will tell you how to comply with the 60-day rule so you can avoid fraud charges and hefty fines and penalties.
IMPORTANT: The 60-day rule affects all Medicare and Medicaid providers (hospitals, nursing homes, outpatient practices, clinics, home health agencies, etc.)
In 2014, Medicare Recovery Audit Contractors identified approximately $2.39 billion in overpayments. And based on expected trends, overpayments in 2015 and 2016 will be higher. With this kind of money on the table, Medicare has a pretty big incentive to aggressively go after these funds – and you.
- How do you determine if a payment is actually an overpayment?
- When is an overpayment considered “identified.”
- When does the 60-day clock actually start ticking?
- Who should you report identified overpayments to?
- What are the specific documentation requirements regarding overpayments?
- What action should you take if you receive an overpayment notification?
- What is the best way to determine the amount to be repaid?
- When can you stop the clock on the repayment 60-day deadline?
- What are the acceptable methods for issuing repayments – check, electronic, etc.?
- And so much more…
You should know that the government plans to vigorously enforce the 60-day overpayment rule. In fact they’ve already taken legal action (Kane v. Healthfirst, Inc. et. al). seeking almost $10,000,000 in damages in a case where they contended that a company didn’t repay overpayments quickly enough.
This training session is essential for hospitals, clinics, long-term care facilities, physicians, medical group administrators or managers, health care consultants, etc. EVERYONE that receives payments from Medicare or Medicaid must comply.
This rule is now in effect. Order this must-attend session today to ensure you can protect yourself and your organization from fraud allegations and massive fines. Don't wait, order today.
CEU's: This program meets AAPC guidelines for 1.0 CEU. On Demand product requires successful completion of a Post-Test for Core A, CPCO and CPMA for continuing education units.
Meet Your Expert: Linda A. Baumann, JD
Linda Baumann is a partner at Arent Fox LLP and heads the Washington, DC office of the health care group. She concentrates her health law practice on matters involving fraud and abuse, government and internal investigations, compliance and Medicare/Medicaid reimbursement. She counsels clients nationwide on False Claims Act cases, the Stark Law, the Anti-Kickback Statute and regulatory compliance. She also has helped clients submit various types of self-disclosures. Ms. Bauman is the former Chair of the ABA Health Law Section and the Editor in Chief of Health Care Fraud and Abuse: Practical Perspectives (3rd ed. 2013). She received her J.D. from Columbia University Law School and her B.A. from Brown University.