Friday, April 1, 201112:00-1:15 pmAt the Institute on Medicare and Medicaid Payment Issues
March 30-April 1, 2011
Baltimore Marriott Waterfront Hotel
Baltimore, MD
Title: Where the Rubber Hits the Road: How to Actually Live with the New Sixty-Day Duty to Disclose and Refund Overpayments
Description:
By now, all in-house counsel must be aware that the arguably most significant compliance challenge under the Patient Protection and Affordable Care Act of 2010 arises under Section 6402. Under this new law, providers, suppliers, Medicare Advantage and Medicaid managed care plans and prescription drug plans must now report and refund overpayments within sixty days of the date the overpayment is identified. Failure to do so could result in a False Claims Act violation, a civil monetary penalty, or other penalties. It is easy to describe what the law says, but it is very difficult to apply it in the real world. This discussion will address steps in-house counsel are (or should be) taking to actually implement the law.
For example:
- How is this affecting internal investigations?
- When should an organization acknowledge that they "identified" an overpayment?
- How to handle the everyday "noise level" repayments?
- Do compliance, legal, and finance need a much more integrated intake and processing approach?
The Centers for Medicare and Medicaid Services regulations are expected to clarify these issues—and may be published by the time of our lunch. But even if regulations are not published, Section 6402 is in effect now. Larry Vernaglia, chair of the Health Care Industry Team at Foley & Lardner LLP will discuss these issues and focus on the decisions and practical considerations with which in-house counsel are actively dealing.
Speaker:
Lawrence W. Vernaglia, Esquire
Partner, Chair of the Health Care Industry Team
Foley & Lardner LLP
Boston, MA