Anesthesia Business Consultants reports CMS clarified the overpayment rule, stating the overpayment occurs when the provider “has, or should have through the exercise of reasonable diligence, determined that the person has received an overpayment and qualified the amount of the overpayment.” From that moment, the provider has 60 days to repay Medicare.
The physician must conduct an investigation of the payment within six months of receiving the payment, with extraordinary circumstances as an exemption.
The Final Rule also defines the look back period as six years instead of 10 years, which was outlined in the proposed rule. The overpayment only needs to be returned if identified within six years of receiving the overpayment.
CMS also outlined methods for reporting and returning the overpayment in the Final Rule and those that aren’t compliant could be subject to False Claims Act or Civil Monetary Penalties Law liability. The rule went into effect yesterday.
More articles on anesthesia:
Top 5 highest & lowest paying states for anesthesiologists
Surgical, general anesthesia does not cause significant long-term cognitive decline: 4 points
Sheridan Healthcare, Candescent expand partnership to South Florida radiology practice: 5 key notes
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
