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Posts tagged "requirement"

Federal Court Provides First Decision on ACA 60 Day Self-Disclosure of Overpayment Rule

The Affordable Care Act requires providers to return overpayments to federal health care programs within 60 days of identification. Neither the ACA nor federal regulations specifically define when an overpayment is "identified" for purposes of beginning the 60-day clock. In 2012, CMS issued a proposed rule (never finalized) that would define an overpayment to be identified when a person has actual knowledge of, or acts in deliberate ignorance/reckless disregard of the overpayment's existence. The provider community rejected this definition as being too broad, arguing that an overpayment should only be "identified" when the actual amount of the overpayment was determined.

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