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The Final 60-Day Rule Is Finally Here!

The Centers for Medicare & Medicaid Services (CMS) has finally published the long-awaited final rule establishing a process for Medicare Part A and B providers and suppliers to report and return overpayments within 60 days (the “60-day rule").    As discussed in detail in a previous post, the proposed 60-day rule was published nearly four years ago, and it understandably sparked a high degree of anxiety for the provider community.  Upon an initial review CMS appears to have made an effort to address at least some of those concerns by, for example, decreased the lookback period from ten to six years.   We are in the process of preparing a full analysis of other provisions - especially the definition of "identified" - that will be published in the next day or so.  In the meantime we are providing a comparison of the proposed and final rule to expedite your review of the changes.

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Karen S. Lovitch

Chair, Health Law Practice & Co-Chair, Health Care Enforcement Defense Practice

Karen advises industry clients on regulatory, transactional, operational, and enforcement matters. She has deep experience handling FCA investigations and qui tam litigation for laboratories and diagnostics companies.