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Healthcare providers face inevitable overpayments from CMS, but the consequences of mishandling them can be severe. The Centers for Medicare & Medicaid Services recently updated its 60-Day Rule, fundamentally changing how providers must identify and return overpayments to avoid False Claims Act liability and substantial penalties.
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Overview
Ralph Levy and Julia Thibault recently wrote an article for Healthcare News titled, “Overpayments Happen: Understanding CMS’s Updated 60-Day Rule,” discussing how overpayments are inevitable, and providers need processes to identify and return them promptly. Failing to do so can lead to False Claims Act liability, which includes hefty penalties. “In January 2025, CMS made long-awaited updates to the 60-Day Rule.…This change strikes what some have long argued is a better balance regarding intent: providers cannot simply avoid liability by ignoring a potential overpayment, but knowledge is still required just as with any other FCA violation,” they stated. To learn more, click here.
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