Simple Reality for Healthcare Providers: Retaining Medicare Overpayments Is Theft

On a regular basis, HHS-OIG releases the results of an audit, examining the high rate of Medicare overpayments by Medicare contractors. Oftentimes, the report includes general recommendations and admonishments about how the government should do a better job policing Medicare contractors. While the government should certainly improve its oversight of those inking Medicare checks, the onus also falls on healthcare providers who receive erroneous payments from Medicare contractors.

For years, however, dishonest healthcare providers oftentimes engaged in a “finders’ keepers” approach to the receipt of Medicare overpayments. Until the False Claims Act Amendments of 2009, the False Claims Act was largely ineffective in reaching those billing practices. For added pressure, regulations clearly state that providers must promptly and fully report, explain, and return all overpayments within sixty days of identifying the erroneous payment.

Periodically, hospital administrators are facing this fact pattern and weighing their options. However, there is only one right option—pay back the funds immediately. If hospital administrators choose and justify a different course, their moral colleagues should step forward and file a qui tam action that seeks to recover these stolen funds.

More information for whistleblowers is located at the Nolan Auerbach & White website.