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Repayment Delay Triggers False Claims Act Settlement for Double Damages

A cardiovascular group recently agreed to pay over $440,000 to settle false claims allegations that they failed to timely report and return $175,000 in overpayments owed to federal healthcare programs. Under the 60-Day Repayment Rule, healthcare providers must repay credit balances owed to federal payers within 60 days of identifying the overpayment. The government intervened following a whistleblower lawsuit filed by a former employee of the medical group. This is only the second reported settlement under the 60-Day Repayment Rule; the first resulted in treble damages. These settlements confirm the Department of Justice’s commitment to using the False Claims Act to enforce the rule and underscores the importance for practices to implement policies to identify and report overpayments. For more information, MGMA has a member-benefit analysis on the rule prepared by MGMA’s Washington Counsel.