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CMS clarifies 60-day rule, lookback period for overpayments

The rule shortens the lookback period and gives providers some breathing room with the 60-day rule
February 16, 2016 | By
Tools

The Centers for Medicare & Medicaid Services (CMS) has finalized rules that specify when the 60-day clock begins ticking for providers to return overpayments, and shaves four years off of the overpayment lookback period.

The 60-day rule eagerly anticipated among providers who weren't sure at what point the rule applied or how CMS defined when a provider officially "identified" an overpayment. The finalized rule indicated that providers should start the 60-day clock once they have quantified an overpayment following "the exercise of reasonable diligence." Additionally, CMS loosened the burden of identifying overpayments by shortening the amount of time providers are required to investigate overpayments from 10 years to six. Article

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