Medicare Overpayments: What Do You Do And When?

Event Information
Product Format
Prerecorded Event
Conference Date
Thu, Apr 14, 2016
60 minutes
Product Description

Understand Refund Guidelines, Fraud Risks & Your Rights Related to Medicare Overpayments

Providers nowadays have much at stake when they discover possible Medicare overpayments. Just keeping the overpayment is not an option. Recently finalized rules generally require that overpayments be identified and returned within 60 days. However, addressing overpayments is far from simple. As a result, physicians and others are often still unsure as to their refund obligations.

Based on the standards identified in the new rules, providers need to understand the circumstances when a receipt is actually an overpayment according to Medicare. Since the time starts ticking as soon as an overpayment is discovered, it is important to understand the ways to stop the repayment deadline. Likewise, providers need to be very clear on whether or not they can apply an overpayment to claims that were underpaid or denied. The manner of calculating a refund should also be consistent with the new rule. Providers also need to be aware of their rights and options to challenge an alleged overpayment, and the fraud risks they face if overpaid funds are retained.

This session with expert speaker Wayne J. Miller, Esq. will educate you on how to define excess payments under Medicare. Based on the new overpayment rule, this session will discuss best practices for identifying and repaying funds. Also, the method of responding to a discovered excess payment will be discussed, as well as formal appeal procedures that are available to providers.

Session Highlights:

  • What constitutes a Medicare “overpayment” according to the law?
  • Circumstances that don’t necessarily require a refund
  • When repayment is due, and how to stop the clock
  • Avoiding potential false claim liability for violating the law
  • Defenses against a potential excess payment claim
  • Whom do you contact to address alleged overpayments?
  • Appeal options and procedures
  • What are the liabilities for non-compliance?
  • How to approach disclosure?

Session Agenda:

  • What’s an overpayment
  • Final 60 Day Rule
  • Rule when Overpayment Refund is due
  • Overpayment diligence process
  • Reporting, satisfying obligation
  • Self disclosure protocol option
  • Internal review considerations
  • Compliance Program Benefits
  • Possible defenses to refund, penalties
  • Medicare appeal rights
  • Waiver of liability

Who should attend?

  • Physicians
  • Medical groups
  • Administrators
  • Managers
  • Hospitals
  • Long term care facilities
  • Health care consultants

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

Order Below or Call 1-844-384-4744 Today

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About Our Speaker

Wayne J. Miller - Healthcare Compliance Expert

Wayne J. Miller, Esq., is a founding partner of the Compliance Law Group, Los Angeles, a law firm focused on health care industry legal compliance for clients nationwide. Wayne has practiced healthcare business and regulatory law throughout his 30-year career. His firm represents a wide range of healthcare industry clients throughout the nation. He is a frequent speaker for The Coding Institute national teleconferences on healthcare reimbursement, transactional and regulatory...   More Info
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