Yesterday, CMS issued a final rule for Medicare Parts A and B overpayments. The rule (and its corresponding statute) requires providers and suppliers to report and return overpayments by the later of the date that is 60 days after the date an overpayment was identified or the due date of any corresponding cost report.

CMS’s rule adds additional clarifications to the requirement to return overpayments. The final rule defines identification, creates a lookback period, and creates a mechanism for reporting and returning overpayments. An overpayment is “identified” when a “person has, or should have, through the exercise of reasonable diligence, determined that the person has received an overpayment and quantified the amount of the overpayment.” However, suppliers and providers are only required to report and return overpayments identified within six years of the date of the overpayment. Finally, the rule permits suppliers and providers to return overpayments through multiple mechanisms, including claims adjustment, credit balance, and self-reported refunds.

The final rule is at the following link.