For PTs billing Medicare, the document offers welcome clarity.
For a full 6 years after passage of the Affordable Care Act (ACA) in 2010, health care providers, including physical therapists (PTs), were expected to report and refund overpayments for services, even though specific requirements for doing so were not yet in place.
A final rule published February 12 by the Centers for Medicare and Medicaid Services (CMS) finally clarifies the matter. The "Reporting and Returning of Overpayments Final Rule" (aka the 60-day rule) implements ACA Section 6402(a). The main provision, effective March 14, requires providers and suppliers receiving funds under Medicare parts A and B to report and return overpayments within a specified time period to either the Office of the Secretary of the Department of Health and Human Services (HHS), an intermediary, a carrier, or a contractor—whichever is appropriate. The overpayment must be returned within 60 days after it was identified or the date on which any corresponding cost report is due, whichever is later.