In response to CMS' proposed rule that would establish deadlines for reporting and returning overpayments, the American Hospital Association wrote a letter to CMS Acting Administrator Marilyn Tavenner saying the provision — which is part of the Patient Protection and Affordable Care Act — would only "create another confusing, onerous and legally risky set of expectations for hospitals."
The 11-page letter listed comments for nearly every provision of the proposed rule, which was released in February. The rule would require hospitals, physicians and other healthcare providers that receive Medicare funds to report and return self-identified overpayments within 60 days of when the overpayments were identified or when any corresponding cost report is due — whichever is later.
Previously, providers did not face a specific deadline for returning an overpayment, but the proposed rule would make it a violation of the False Claims Act if the incorrect payment is not returned to CMS within 60 days.
AHA said CMS should revisit the proposed rule's framework, saying there are already overpayment processes and compliance activities in place. The trade association also said the 10-year look back period would "improperly disturb the balance of administrative finality and unlawfully impose retroactive FCA liability."
"The emphasis should be on minimizing unnecessary burden and assuring coordination with the many existing and varied reviews, reviewers and processes already imposed on hospitals," the letter stated. "And [CMS] should do so in accord with the clear intent of the law to provide a safe and reliable way in which hospitals can return payments mistakenly received from the government."
CMS will release a final rule over the coming months after it addresses all accepted comments.
The 11-page letter listed comments for nearly every provision of the proposed rule, which was released in February. The rule would require hospitals, physicians and other healthcare providers that receive Medicare funds to report and return self-identified overpayments within 60 days of when the overpayments were identified or when any corresponding cost report is due — whichever is later.
Previously, providers did not face a specific deadline for returning an overpayment, but the proposed rule would make it a violation of the False Claims Act if the incorrect payment is not returned to CMS within 60 days.
AHA said CMS should revisit the proposed rule's framework, saying there are already overpayment processes and compliance activities in place. The trade association also said the 10-year look back period would "improperly disturb the balance of administrative finality and unlawfully impose retroactive FCA liability."
"The emphasis should be on minimizing unnecessary burden and assuring coordination with the many existing and varied reviews, reviewers and processes already imposed on hospitals," the letter stated. "And [CMS] should do so in accord with the clear intent of the law to provide a safe and reliable way in which hospitals can return payments mistakenly received from the government."
CMS will release a final rule over the coming months after it addresses all accepted comments.
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