First 60-day repayment rule settlement announced

Originally published in  the August 31, 2016 issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

Three hospitals within the Mount Sinai Health System agreed to pay nearly $3 million to settle a whistleblower lawsuit alleging they held onto Medicare and Medicaid overpayments after the 60-day repayment window. This is the first settlement coming from the final 60-day repayment rule issued by the Centers for Medicare & Medicaid Services (CMS), which requires all overpayments to be reported and returned within 60 days of identification. Under the final rule, “identified” is defined as when the person has, or should have through the exercise of reasonable diligence, determined that the person has received an overpayment and quantified the amount of the overpayment. More cases and settlements are expected. For more information, MGMA has a member-benefit webinar entitled “Medicare’s 60-Day Repayment Rule: What You Need to Know” and analysis on the rule prepared by MGMA’s Washington Counsel.


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