Key Takeaways from CMS Part A/B Overpayments Final Rule

After nearly four years, CMS has revised and finalized its proposed rule offering guidance to Medicare Part A and B providers and suppliers as to how they can fulfill their statutory obligations to report and return “identified” overpayments.  CMS altered a number of its proposals, including adopting a six-year lookback period, rather than ten.  Perhaps most critically for providers, the Agency departed from its earlier interpretation of “identified” to allow for some length of time—generally six months, except in extraordinary circumstances—to quantify overpayments before the sixty-day repayment clock begins to run.

In an article available here, we provide further analysis of CMS’ final rule and discuss implications for qui tam suits and corporate compliance programs.  A copy of the final rule is available here.