CMS Proposes 10-Year Lookback Period for Overpayments to Medicare Program

February 22, 2012 | Strategic Insights for Health System


As required by the Patient Protection and Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule outlining the process for reporting and returning overpayments made by the Medicare program. While the federal government has sought to recover overpayments in the past, the Affordable Care Act authorizes the federal government to levy civil monetary penalties against anyone who fails to report and return a known overpayment within the statutory time limit. An overpayment could include, for example, payment for a noncovered service or payment in excess of the allowable amount. The proposed rule, published in the February 16, 2012, Federal Register, says that overpayments must be reported and returned by the later of either 60 days after the payment is identified or the date any corresponding cost report is due.

Access Full Content

Contact us today at 610.825.6000.