February 26, 2015

CMS Extends Timeline for Overpayments Final Rule

The Feb. 17 Federal Register announced a one-year extension of the timeline for publication of a final rule forthe reporting and returning of overpayments under the Medicare program. The Social Security Act requires notice to be provided in the Federal Register if there are exceptional circumstances that result in publication of a final rule more than three years after the publication date of the proposed rule. In this case, the Centers for Medicare & Medicaid Services (CMS) indicated the complexity of the rule and scope of comments warrants the extension of the timeline for publication.

Section 1128J(d)(1) of the Act requires a person, who has received an overpayment, to  report and return the overpayment to the Secretary, the State, an intermediary, a carrier, or a contractor, as appropriate, at the correct address, and to notify the Secretary, State, intermediary, carrier or contractor to whom the overpayment was returned in writing of the reason for the overpayment. Section 1128J(d)(2) of the 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. This notice extends by one year, until Feb. 16, 2016, 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 as outlined in the Feb. 16, 2012 proposed rule.

The notice, however, includes a reminder to all stakeholders that even without a final regulation they 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.

For more information, contact Kathy Reep , vice president of finance, at (407) 841-6230.