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CMS Issues Proposed Rule on Reporting and Returning Overpayments

One of the provisions of the Affordable Care Act (“ACA”) that has gotten a great deal of attention is Section 6402(a), which requires a person who receives an overpayment to report and return the funds within 60 days after the overpayment is identified (or the date any corresponding cost report is due, if applicable.) The provision is significant because the failure to report and return overpayments creates False Claims Act liability, exposure to Civil Monetary Penalties, and potentially exclusion from participation in the federal programs.

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Reverse False Claims-The Latest in False Claims Act Exposure

Earlier this week, the Department of Justice announced that it had its second largest annual recovery of civil fraud claims in history, securing $2.4 billion in settlements and judgments in cases involving fraud against the government in the fiscal year ending Sept. 30, 2009.

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Health Care Reform Requires Immediate and Longer Lead Time Changes Regarding CT, MRI and PET Scans

As we continue to review the recently enacted Patient Protection and Affordable Care Act, what is immediately striking is the broad range of regulatory requirements that will impact health care providers. Some of these requirements will not go into effect for a year or more. However, one requirement that became effective immediately upon the President signing the bill relates to in-office referrals for CT, MRI or PET scans.

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