Medicare and Medicaid Repayments and Disclosures

Meeting Refund and Reporting Obligations to Comply With Regulatory Requirements

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


Conducted on Wednesday, January 9, 2019

Recorded event now available

or call 1-800-926-7926
Program Materials

This CLE webinar will guide healthcare counsel on the legal obligations, benefits, incentives, and risks of reporting and repaying improper Medicare and Medicaid payments. The panel will offer best practices for complying with the requirements for reporting and returning overpayments.

Description

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 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 performed, the claim was submitted in violation of the Stark law violation, etc.

Providers that fail to report and refund overpayments within 60 days 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 best practices for complying with the requirements for reporting and returning overpayments.

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Outline

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

Benefits

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?
  • What factors should healthcare providers consider when determining where to make a disclosure?
  • Practical considerations when investigating potential overpayments, including when performing audits, analyzing error rates, and using statistical sampling
  • The effect of the 60-day refund statute on overpayments involving Medicaid, Medicare Advantage, and Medicaid Managed Care plans

Faculty

Roth, Robert
Robert L. Roth

Partner
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

Partner
Drinker Biddle & Reath

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

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