The Centers for Medicare & Medicaid Services (CMS) has failed to finalize the rule regarding Medicare overpayments within 60 days of identifying them because there are several policy and operational issues that need to be resolved in order to ensure appropriate coordination with other government agencies such as the Office of Inspector General (OIG). Even though the proposed rule has been before the public for the past three years and a final rule has not yet been published, CMS emphasizes that the 60-day reporting and repayment statute is in force under the Affordable Care Act.
Providers will still be held accountable for reporting and returning Medicare overpayments within the appropriate time frame even if specific regulations are not yet in place. Providers who fail to return an overpayment within the 60-day period could be in trouble under the False Claims Act if a prosecutor can convince a judge that the provider knew about the overpayment or even should have known about it.