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Monitoring repayments under the 60-day overpayment rule

Betsy Wade (bwade@signaturehealthcarellc.com) is the Chief Compliance and Ethics Officer at Signature Healthcare in Louisville, KY.

With the start of a new calendar year, it’s a good time to revisit your compliance monitoring plan to ensure your department is tracking and reporting repayments under the 60-day overpayment rule.[1]

Promulgated under the 2010 Patient Protection and Affordable Care Act, the 60-day rule stipulates when a provider must repay an “identified” overpayment to the government. Failure to return a known overpayment within the 60-day time frame can result in federal False Claims Act liability, Civil Monetary Penalties Law liability, and exclusion from federal healthcare programs.

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