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The FCA Payback on Medicare Overpayments

Client Alert | less than 1 min read | 03.07.16

In February, the Centers for Medicare & Medicaid Services issued a final rule governing the reporting and return of overpayments for items and services reimbursed under Medicare Parts A and B. A new alert discusses how the final rule clarifies when an overpayment has been identified and how efforts precedent to identifying such overpayments will be important to future enforcement efforts under the FCA.

Insights

Client Alert | 6 min read | 04.29.26

CMS Seeks to Expand Interoperability Requirements to Drug Pre-Authorization (FAQ)

On April 10, 2026, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule (2026 CMS Interoperability Standards and Prior Authorization for Drugs, or CMS-0062-P) outlining the agency’s plans to impose new interoperability requirements on payors participating in certain Medicare and Medicaid programs. As described by the agency in a recent press release, the proposed rule “builds on” prior rulemaking by clarifying and enhancing interoperability requirements for payors’ prior authorization processes, specifically those associated with coverage requests for pharmaceutical therapies....