CMS overpayment rule overreaches, groups say

April 25, 2012

More than 100 professional organizations bashed a proposed federal regulation that would require you to search for and refund Medicare overpayments. See all their gripes.

Groups representing physicians and hospitals lashed out at a proposed federal regulation that would require you to search, report, and return overpayments from the Centers for Medicare and Medicaid Services (CMS) for the past 10 years.

The groups were responding to the proposed rule published February 16 in the Federal Register.

One of the letters, sent April 16, was signed by 110 physician and medical societies, including the American Academy of Family Physicians (AAFP), the American College of Physicians, the American Medical Association, the American College of Osteopathic Family Physicians, the American College of Osteopathic Internists, and the Medical Group Management Association. The groups urged CMS to fix the overpayment proposed rule in several areas, including:

Don’t require physicians to search for overpayments without indicating  that they exist.

Clarify that the 60-day time period in which doctors have to return the overpayments begin when the inquiry has been completed.

Reduce the “look-back” period from 10 years to 3 years.

Consolidate CMS’ other overpayment programs.

Eliminate extraneous overpayment reporting data.

Streamline reporting forms.

Revise the time and financial burden estimate for data collection to a larger, more accurate amount.

In its own letter about the proposed rule sent the previous week, the AAFP highlighted how the overpayment rule would burden smaller practices.

“If the overpayment is less than $100, medical practices will likely expend as much or more to report and return the overpayment, for which they may not even be at fault,” wrote AAFP Board Chairman Roland A. Goertz, MD, MBA, FAAFP. “Therefore, the AAFP urges CMS to consider establishing a minimum overpayment threshold in the spirit of simplifying inadvertent and innocent errors.”

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