Heyl Royster



Clayton and Robinson Author IDC Quarterly on “Reverse” False Claims under FCA


Roger Clayton (Peoria), Chair of the firm's Healthcare Practice, and attorney Tyler Robinson (Springfield) recently authored an article for the Illinois Association of Defense Trial Counsel’s IDC Quarterly (Volume 23), entitled "The Rise of the 'Reverse' False Claim and Proposed Rules from CMS on Reporting and Returning Overpayments." The article discusses the implications of current law, and a set of proposed rules from the Centers for Medicare and Medicaid Services (CMS), on a medical provider’s obligation to diligently investigate, report, and return government overpayments in order to avoid significant liability under the False Claims Act.

The article details the evolution of the False Claims Act to encompass: a provider’s retention of government overpayments, Congress' 60-day deadline to report and return government overpayments, and CMS' proposed rules, which could forever change the manner in which healthcare providers report and return government overpayments. This article is especially of interest to providers enrolled in Medicare programs who may be unfamiliar with new reporting and refunding requirements and the potential complications, including a possible ten-year lookback period, that lie ahead.

Click here to view the full article.