BC Advantage - 2016 Issue 6

Overthinking Overpayments from Medicare

Since passage of the Affordable Care Act, compliance officers and attorneys have struggled to comply with the new rule requiring notification and repayment of Medicare overpayments within 60 days. The two large questions that remain unclear are what constitutes an "overpayment," as well as what it means to "identify" an overpayment. Section 6402(a) of the Affordable Care Act ("ACA") created a new section 1128J(d)(1) of the Social Security Act (the "Act"), which addresses overpayments. Section 1128J(d)(2) requires an overpayment to be reported and returned "by the later of (A) the date which is 60 days after the date...

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