New health care legislation is constantly being drafted, proposed and passed, so it is no surprise that most providers find it challenging to keep up. One of the most important changes in policy to take effect in recent years is the implementation of a rule obligating health care providers to repay any debts resulting from the overpayment of billed Medicare treatment or services.
According to the Department of Health and Human Services, there are a number of new stipulations that providers must adhere to. Failure to do so could lead to liability for three times the amount initially owed. It is best to familiarize yourself with the following facts.
You must report overpayments
The new stipulations place the responsibility of discovery on providers rather than Medicare. This means that you have the obligation to research payments in due diligence and report any overpayment that you find. In identifying the error, you must also submit a written explanation detailing the overpayment’s cause. This applies to Medicare funds for both Part A and Part B.
There is a six year lookback period
The legislature initially proposed a ten year lookback period, but after protestations, this was shortened to six years. Still, Medicare requires that any overpayment discovered within the span of six years be identified, reported and repaid. Upon finding any repayment beyond this time frame, however, you are under no obligation to repay it per the standards of the law.
Debt must be repaid within 60 days
While Medicare has six years to collect from health care providers, you have a mere 60 days to submit repayment of debts owed. This limit begins on the day of the discovery of the overpayment, but if you are unable to repay the debt within that time, you might apply for an extended repayment schedule. This can help you avoid increasing the amount that you owe through penalties.