tci Medicare Compliance & Reimbursement - 2017 Issue 6
Compliance: Steer Clear of The Fire with New Insight on the 60-Day Rule For Overpayments
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Article Overview
This compliance article reviews CMS guidance on Medicare overpayments and the 60-day rule, with emphasis on the timing for identifying, reporting, and returning funds, the updated lookback period, and the practical processes providers and suppliers may use to address overpayments. It is relevant to compliance staff, revenue cycle teams, auditors, and healthcare attorneys who need a general understanding of the federal rule and related enforcement context.
Why This Topic Matters
The article highlights a significant Medicare compliance obligation that can trigger liability if overpayments are not handled on time. It helps readers understand the scope of the rule, the timeframe CMS applies, and the broader enforcement framework surrounding retained overpayments.
What You Will Learn
- The general purpose and compliance significance of the Medicare 60-day rule
- How CMS’s lookback period for overpayment review changed in the final rule
- What categories of providers and programs are discussed in relation to the rule
- The general types of processes CMS recognizes for reporting and returning overpayments
- How the rule fits within broader federal compliance and enforcement context
Who Should Read This
- Healthcare compliance professionals
- Revenue cycle and billing staff
- Healthcare attorneys
- Practice administrators
- Audit and reimbursement teams
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