Event Details
Six Year Look-back Audits and 60 Day Overpayment Rule
Webinar
Thursday, December 14, 2023 ~ 1:00PM - 2:00PM
Six Year Look-back Audits and 60 Day Overpayment Rule
The Affordable Care Act includes the 60-day overpayment rule, which requires suppliers to refund overpayments within 60 days of identification. What many suppliers aren’t aware of though is that if an overpayment is identified, either internally or externally, suppliers are mandated by law to perform a six-year lookback audit. This overly burdensome process has impacted hundreds of suppliers around the country and now that the TPE program has migrated to post payment reviews during the pandemic, this could impact even more suppliers. Even worse, if suppliers do not comply with this rule, they are at risk of false claim penalties. This webinar will provide an overview of what is required of a supplier who is faced with an overpayment, how to manage the situation, what risks are associated with the overpayment rule and most importantly, how to mitigate your risk when dealing with this process.
Learning Objectives:
- Identify situations in which the 60-day overpayment rule is applicable
- Understand what steps a provider must take in the event of an overpayment
- What can providers do to mitigate risk associated with the 60-day overpayment rule
- Review the 60-day overpayment rule and the six-year lookback obligation
- Know the steps that suppliers can take to reduce the risk of being subjected to the 60-day overpayment rule
- Set out the steps the supplier should take to successfully fulfill its obligations under the rule
Areas Covered in the Session:
- Six Year Lookback Background
- 60-day Overpayment Rule
- OIG Report, Discovery & Recommendations
- Revocation Risks & Proving a Pattern
- Contractor Response-Timelines & Instructions
- Impact
- OIG Workplan
- Legal Implications
- What to Anticipate
- Proactive Approach
- Live Q&A session