If health care providers aren't already concerned about repayment changes in the Affordable Care Act, they'd better get concerned — and fast.
That was the advice of several attorneys at Friday's eighth annual Kansas Health Law Institute, a daylong seminar hosted by Foulston Siefkin for health industry executives.
Attorneys from the firm traditionally start the seminar with a "Top 10" list of health care changes. This year's list focused entirely on the new legislation.
The only dispute was whether repayment changes should be No. 1 ("Much Ado About Nothing?" got that spot) or No. 2.
Health care providers have always been expected to return any Medicare or Medicaid overpayments.
But the new law has a "Give me the money now... or else" provision, said attorney Gary Ayers.
Overpayments have to be reported and returned within 60 days of their identification, said Scott Palecki, his colleague.
Providers who don't do so could face liability under the False Claims Act and a tripling of fines.
"The big deal is the 60 days," said attorney Stan Andeel. "The government is trying to put teeth in this."
That part of the act became effective March 23, the attorneys said.
With court challenges already filed and elections in November, the No. 1 issue of the Affordable Care Act is whether it will continue to exist as it does now, they said.
Because some provisions of the act, such as coverage for pre-existing conditions, are "reform we can agree on," the act won't all be repealed, Ayers said. But if Republicans control Congress after the November elections, they may "slow-walk" implementation.
These are among other issues that made the attorneys' list:
* Expanded enforcement, because much of the act is to be funded by fighting fraud and abuse.
* Mandatory compliance programs for new providers and suppliers. Attorney Justan Shinkle said the requirements might end up applying to current providers and suppliers, too.
* Changes to Stark Law that will affect referrals for ancillary services owned by physicians and construction at physician-owned hospitals. "The risk in this area is huge," Palecki said. "Get it documented."
* A focus on quality that will shift payment models away from fee for service.