Physician responsibilities for suspected Medicare overpayments

From international law firm Arnold & Porter LLP comes a timely column that provides views on current regulatory and legislative topics that weigh on the minds of today’s physicians and health care executives.Have you ever heard someone in your office say, “I think Medicare may not have paid these claims correctly?” After that statement, did the relevant documents get buried in a pile on a desk — never to be reviewed again? Be careful. Earlier this year, CMS issued a final rule governing the responsibility of providers to report and return Medicare overpayments. The rule makes clear that providers are responsible for identifying and repaying overpayments that may have occurred within a 6-year lookback period, and repayment must be made to Medicare within 60 days of identifying the overpayment. Failure to take action could trigger liability under the “reverse” false claims provisions of the federal False Claims Act, which punish the retention of federal dollars paid in excess of the actual amount to which the provider was entitled.