The 60-day repayment rule was implemented by the Centers for Medicare and Medicaid Services (CMS) effective March 14, 2016 to clarify Medicare providers’ obligations to investigate, report, and refund identified overpayments under the Affordable Care Act. The rule specifically details what it means to “identify” an overpayment and explains how to report and return identified overpayments to CMS.1 The rule also states that an overpayment must be reported and returned if it is identified within six years of the date it was received. This time period is generally referred to as the “lookback” period.
Continue Reading Lookback Periods for Medicaid Overpayments
Missouri
State Anti-Subrogation Law Is Preempted With Respect to Federal Employee Insurance Contract
Insurers providing health care benefits to federal employees can obtain reimbursement when their insured obtains a tort recovery, despite a state law prohibiting such reimbursement, based on the preemption provision of the Federal Employees Health Benefits Act (FEHBA), pursuant to the U.S. Supreme Court’s decision in Coventry Health Care of Missouri, Inc., fka Group Health Plan, Inc. v. Nevils, issued April 18, 2017.
Continue Reading State Anti-Subrogation Law Is Preempted With Respect to Federal Employee Insurance Contract
Missouri tort reform reformed again: medical malpractice damage caps reinstated
On May 7, 2015, Governor Jay Nixon signed Senate Bill 239 into law and reinstated damage caps for Missouri medical malpractice cases. While Missouri law previously limited damages in wrongful death actions, healthcare providers faced limitless verdicts in all other medical malpractice lawsuits. Not anymore.
Under the new law, plaintiffs cannot recover more than $400,000 for non-economic damages in medical malpractice actions. If the case involves claims of catastrophic personal injury or wrongful death, the cap is increased to $700,000. The term “catastrophic personal injury” is defined by statute to include cases of quadriplegia, paraplegia, loss of 2 or more limbs, brain injuries involving permanent cognitive impairment, irreversible major organ failure, or severe vision loss.
Continue Reading Missouri tort reform reformed again: medical malpractice damage caps reinstated