Handling Medicare and Medicaid Overpayments: Provider Refund and Reporting Obligations, Avoiding Penalties
On Wednesday, July 30, Judith “Judy” Waltz, chair of Foley’s Health Care Practice Group will join the Strafford webinar titled “Handling Medicare and Medicaid Overpayments: Provider Refund and Reporting Obligations, Avoiding Penalties.”
Health care providers must report and return overpayments to Medicare and Medicaid, regardless of whether the overpayment resulted from a Medicare contractor error or provider error. Overpayments occur in a variety of circumstances — the claim was for services not covered by Medicare or not medically necessary, the payment was for a higher level of services than were performed, the claim was submitted in violation of the Stark law, etc.
Providers that fail to report and refund overpayments within 60 days risk violating the False Claims Act.
Health care providers must determine the amount of overpayment, the reporting and refund obligations, and the government’s recovery rights when considering whether and when to make disclosures and repayments to Medicare and Medicaid.
Listen as our authoritative panel of health law attorneys examines the legal obligations, benefits, incentives and risks of disclosure and repayment, and the impact of the Affordable Care Act (ACA) on mandatory repayment requirements. The panel will offer best practices for complying with the requirements for reporting and returning overpayments.
Outline of the program:
- Medicare requirements for overpayment
- Benefits, incentives, risk of disclosure
- Best practices for investigating and responding to potential overpayments
The panel will review these and other key issues:
- What are the obligations concerning potential overpayments?
- What are the benefits and incentives for refunding and disclosing overpayments? What are the risks?
- What factors should health care providers consider when determining where to make a disclosure?
- Practical considerations when investigating potential overpayments, including when performing audits, analyzing error rates, and using statistical sampling.
- The effect of the 60-day refund statute on overpayments involving Medicaid, Medicare Advantage, and Medicaid Managed Care plans.
CLE
Strafford is offering CLE for their program.
