Navigating Reverse False Claims and Medicare Overpayments Amid Strict Enforcement of the 60-Day Rule

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

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Conducted on Wednesday, December 17, 2014

Recorded event now available

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Course Materials

This CLE course will provide guidance to healthcare counsel on reverse false claims enforcement trends and overpayment requirements. The panel will examine the impact of recent developments, including recent cases and government policies, and offer best practices for navigating reverse false claims.


The U.S. Department of Justice and New York State AG intervened in a federal False Claims Act (FCA) case in June 2014 that is one of the first reverse false claims cases brought by the government based only on the healthcare provider’s alleged failure to refund an overpayment within the 60 days required by the Affordable Care Act.

The Affordable Care Act established that any person who receives an overpayment from the Medicare or Medicaid programs — and who does not report and return the overpayment within 60 days after “identification” — will be subject to potential FCA liability. FCA liability can result in costly penalties and treble damages.

The government’s intervention signals that the 60-day rule will be strictly enforced. It is now more important than ever for healthcare counsel to understand the implications of the FCA, the 60-day rule, and be able to navigate reverse false claims and overpayment obligations.

Listen as our panel examines recent developments related to reverse false claims liability, including recent cases and the DOJ's new policies, as well as disclosure obligations. The panel will offer best practices for meeting obligation requirements and navigating reverse false claims liability.



  1. Intro and Overview
  2. Overpayments and the 60-Day Rule
    1. Brief background (FERA/ACA)
    2. Part A&B Proposed Rule
    3. Part C&D Proposed Rule & Final Rule issued in Spring 2014
  3. Recent Developments — Reverse False Claims Act Litigation
    1. Pending Intervened Continuum Case
    2. Qui Tams and Reverse False Claims
  4. Best Practices
    1. Investigations/Audits
    2. Disclosure options


The panel will review these and other key issues:

  • What are the recent developments impacting FCA “reverse false claims” enforcement in the healthcare industry?
  • What are the implications of the government’s intervention in the reverse false claims case?
  • What steps should healthcare counsel and providers take to ensure compliance with the Affordable Care Act’s overpayment requirements?


Greenberg, David
David S. Greenberg

ArentFox Schiff

Mr. Greenberg advises health care companies, including providers and suppliers, through an exceedingly...  |  Read More

Adam D. Romney
Adam D. Romney

Davis Wright Tremaine

Mr. Romney supports health care providers on multiple issues including Medicare and Medicaid reimbursement,...  |  Read More

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