Practical Effects of Change to Liability Standard Under 60-Day Repayment Rule
- February 03, 2023
- Mark R. Fitzgerald , Powers Pyles Sutter & Verville, PC
A recent proposed change to the 60-day repayment rule could affect how providers assess their potential liability for overpayments and their choices regarding repayment. On December 27, 2022, the Centers for Medicare & Medicaid Services (CMS) proposed a change to the standard of care required under the 60-day repayment rule (Overpayment Rule) as part of a group of policy and technical changes to the Medicare program.[1] The change would affect traditional Medicare, as well as Medicare Advantage (MA) and Medicare Part D. If adopted, the change will be welcome news for providers as it will raise the standard for liability under the federal False Claims Act (FCA) for failure to report and repay an identified overpayment from ordinary negligence to “reckless disregard.”[2]
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