News & Analysis as of

False Claims Act (FCA) Civil Monetary Penalty Final Rules

Venable LLP

The Administrative False Claims Act: 10 Fast Facts That Matter

Venable LLP on

The Administrative False Claims Act (AFCA), enacted in December 2024, expands agency authority and recovery limits, making the AFCA a more powerful tool for recouping government funds lost to alleged false claims—a...more

Burr & Forman

Failure to Return Credit Balances (Especially to Medicare and Medicaid) Can Create Significant Liability

Burr & Forman on

Every health care provider has “credit balances,” which occur when a provider receives more money than it is owed for services rendered. Credit balances can be caused by a number of factors, including incorrect coding,...more

Goodwin

Watch the Clock! CMS Makes Important Changes to Medicare Overpayment Rules

Goodwin on

The Centers for Medicare & Medicaid Services (CMS) recently made meaningful changes to its regulations interpreting the Affordable Care Act’s (ACA’s) so-called “60-day Rule,” which requires Medicare providers to affirmatively...more

Foley & Lardner LLP

Medicare Overpayments: CMS Issues Final Regulations Implementing Changes to 60-day Refund Rule

Foley & Lardner LLP on

On Friday, November 1, 2024, the Center for Medicare & Medicaid Services (CMS) issued the display copy of the final rule interpreting the 60-day Refund Rule for Medicare Parts A/B (Traditional Medicare) and C/D (Medicare...more

Akin Gump Strauss Hauer & Feld LLP

Red Notice Newsletter - Russian

ANTICORRUPTION DEVELOPMENTS - Mega International Commercial Bank Co. Ltd. Fined $29 Million - On January 17, 2018, the U.S. Federal Reserve Board assessed Taiwan based bank Mega International Commercial Bank Co. Ltd. a...more

Akin Gump Strauss Hauer & Feld LLP

Red Notice Newsletter - Chinese

ANTICORRUPTION DEVELOPMENTS - Mega International Commercial Bank Co. Ltd. Fined $29 Million - On January 17, 2018, the U.S. Federal Reserve Board assessed Taiwan based bank Mega International Commercial Bank Co. Ltd. a...more

Akin Gump Strauss Hauer & Feld LLP

Red Notice Newsletter - January 2018

ANTICORRUPTION DEVELOPMENTS - Mega International Commercial Bank Co. Ltd. Fined $29 Million - On January 17, 2018, the U.S. Federal Reserve Board assessed Taiwan based bank Mega International Commercial Bank Co. Ltd....more

McDermott Will & Schulte

New OIG Exclusion Regulations About to Go into Effect

The Office of Inspector General (OIG) recently published a final rule regarding its exclusion authorities. The final rule goes into effect March 21, 2017, and expands OIG’s authority to exclude certain individuals and...more

Hogan Lovells

HHS OIG Finalizes New Exclusion Rules as Administration Exits

Hogan Lovells on

With just a week left before a new administration takes office, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) finalized changes to the regulations authorizing OIG to exclude...more

Mintz - Health Care Viewpoints

At Long Last, OIG Issues Final Rule for Beneficiary Inducement Safe Harbors

More than two years since issuing the proposed rule, the HHS Office of the Inspector General (OIG) issued the long-awaited and highly anticipated final rule (the Final Rule) that provides amendments to the Anti-Kickback...more

Mintz - Health Care Viewpoints

Penalties For Health Care Law Violations Surge

The civil monetary penalties for violations of myriad health care laws continue to rise. In June, we discussed the enormous increase in penalties under the federal False Claims Act (“FCA”). Through an interim final rule, the...more

Baker Donelson

Federal Agencies Forced to Implement Huge Increases in Civil Monetary Penalties for Health Care Fraud

Baker Donelson on

Thanks to section 701 of the Bipartisan Budget Act of 2015, Public Law 114–74, federal agencies have been forced to implement huge increases in penalties intended to deter health care fraud. The Federal Civil Penalties...more

Mintz - Health Care Viewpoints

DOJ Announces Dramatic Increase in False Claims Act Penalties

On May 6th, we posted about the possibility that the Department of Justice (“DOJ”) might dramatically increase False Claims Act (“FCA”) penalties after the Railroad Retirement Board (“RRB”) nearly doubled the per-claim...more

Parker Poe Adams & Bernstein LLP

CMS Finalizes Rule on Reporting and Returning Medicare Overpayments

The Affordable Care Act (sometimes referred to as Obamacare) included a requirement for providers to report and return all Medicare and Medicaid overpayments within 60 days of identification. Although this requirement has...more

Womble Bond Dickinson

Next Steps: Helping Your Organization Implement the New Medicare Overpayment Rule - Part I

Womble Bond Dickinson on

On February 12, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published a final rule that explains the requirements for providers and suppliers reporting and returning overpayments under Medicare Parts A & B (the...more

Pullman & Comley - Connecticut Health Law

Final Rule Clarifies Requirements for Reporting and Returning Medicare Overpayments

Medicare Part A and B providers and suppliers should take note of new regulations recently issued by the Centers for Medicare & Medicaid Services that implement the Affordable Care Act’s 60-day rule on reporting and returning...more

Harris Beach PLLC

Health Care Group News: Final Rule Regarding Return Of Medicare Overpayments Is More Favorable to Providers Than Anticipated

Harris Beach PLLC on

One element of the Affordable Care Act (ACA), enacted in March 2010, requires providers to identify, report and return Medicare overpayments. A provider’s failure to do so can result in False Claims Act liability, Civil...more

Tucker Arensberg, P.C.

Final 60 Day Overpayment Rule

Tucker Arensberg, P.C. on

CMS has issued the final regulations to implement that section of the Affordable Care Act amending the Social Security Act to provide that retention of identified overpayment could be a false claim and be subject to both the...more

Mintz - Health Care Viewpoints

The Final 60-Day Rule: the Good, the Bad, and the Ugly

As we announced on February 11, 2016, the Centers for Medicare & Medicaid Services (CMS) has finally published the long-awaited Final Rule governing the return of Medicare Part A and Part B overpayments within 60 days (the...more

Lathrop GPM

After Nearly Six Years of Uncertainty, CMS Establishes Final Standards for Reporting and Returning Medicare Overpayments

Lathrop GPM on

Background On February 12, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published the long-awaited Final Rule establishing CMS’s official policy for the timely Reporting and Returning of Medicare overpayments...more

King & Spalding

OMB Receives Final Medicare Parts A and B 60-Day Overpayment Rule from CMS

King & Spalding on

On October 21, 2015, the Office of Management and Budget (OMB) received the Medicare Parts A and B overpayment final rule from CMS which is the last phase before the rule is issued in the Federal Register. While the text of...more

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