Medicare and Medicaid Repayments and Disclosures

Meeting Refund and Reporting Obligations to Comply with FERA, FCA and the ACA

Recording of a 90-minute CLE webinar with Q&A

This program is included with the Strafford CLE Pass. Click for more information.
This program is included with the Strafford All-Access Pass. Click for more information.

Conducted on Wednesday, November 5, 2014

Recorded event now available

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Course Materials

This CLE course will provide guidance for healthcare counsel on the legal obligations, benefits, incentives and risks of reporting and repaying improper Medicare payments. The panel will examine the impact of the Affordable Care Act and CMS’s proposed overpayment rule, and outline practical steps to take in response to these changes.


Healthcare providers must report and return overpayments to Medicare and Medicaid, regardless of whether the overpayment resulted from a Medicare contractor error or provider error. Overpayments could occur in a variety of circumstances—the claim was for services not covered by Medicare or not medically necessary, the payment was for a higher level of services than were actually performed, the payment was for a Stark law prohibited violation, etc.

Healthcare reform increases the pressure on healthcare providers to return Medicare and Medicaid overpayments in a timely manner. Providers that improperly fail to report and refund overpayments risk violating the False Claims Act.

Healthcare providers must determine the amount of overpayment, the reporting and refund obligations, and the government’s recovery rights when considering whether and when to make disclosures and repayments to Medicare and Medicaid.

Listen as our authoritative panel of health law attorneys examines the legal obligations, benefits, incentives and risks of disclosure and repayment, and the impact of the ACA on mandatory repayment requirements. The panel will offer practical steps to take in response to the latest legal changes.



  1. Medicare requirements for overpayment
  2. Benefits, incentives, risk of disclosure
  3. Rules of the road in investigating and responding to potential overpayments


The panel will review these and other key issues:

  • What are the obligations concerning potential overpayments?
  • What are the benefits and incentives for refunding and disclosing overpayments? What are the risks?
  • When is disclosure to law enforcement warranted? What is the difference between a law enforcement disclosure and a repayment?
  • What factors should healthcare providers consider when determining where to make a disclosure?
  • What is the government doing to enforce the 60 day rule to refund overpayments?


Roth, Robert
Robert L. Roth

Hooper Lundy & Bookman

Mr. Roth advises clients on matters arising under Medicare and Medicaid, focusing on payment, compliance, and...  |  Read More

Witten, Jesse
Jesse A. Witten

Drinker Biddle & Reath

Mr. Witten counsels on health law issues, including Medicare and Medicaid reimbursement and price reporting...  |  Read More

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