The CMS has finalized a rule that dictates health providers must report Medicare overpayment for the previous six years. When the rule was initially introduced, it required providers to cover the previous ten years. The finalized rule has changed this time period to better fit record keeping, but some professionals still think the time span is unreasonable.
ModernHealthCare.com discusses the controversy.
The rule, first proposed in 2012, alarmed many healthcare organizations when the CMS floated the idea that providers would be liable for returning Medicare overpayments going back as far as 10 years. The American Hospital Association and the Federation of American Hospitals criticized the proposal at the time, saying the time frame was unreasonable.
In response to these objections, the CMS said the period will now be six years. Many providers and suppliers retain records and claims data for between six and seven years based on various existing federal and state requirements.
“Thus, we believe our final rule does not create additional burden or cost on providers and suppliers in this regard,” the CMS said in the rule.
Still, industry stakeholders were disappointed.
“We had requested a three year look back period, but six is better than 10,” said Wanda Filer, President of the American Academy of Family Physicians.
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“We appreciate the CMS’s recognition of the burden extended look back period places on hospitals,” said Sean Brown, spokesman for The Federation of American Hospitals, “We continue to believe, however, that six years is still too much. A four-year look back period is more appropriate and consistent with existing Medicare rules for reopening payment determinations.”
Others agreed.
The rule “still places healthcare providers in a position of having to spend too much time looking back for inadvertent errors thereby shifting their focus away from providing care to their patients and improving healthcare delivery into the future,” said Mark Silberman, a partner at Duane Morris in Chicago.
For more on the pros and cons of this rule, read the full story here.
Photo by Ken Teegardin via Flickr CC License
