How many days does a billing company have to notify authorities after credible evidence of fraud is discovered?

The correct answer is 60 days because federal regulations, specifically under the Affordable Care Act and subsequent guidance from the Centers for Medicare & Medicaid Services (CMS), mandate that when a billing company or a healthcare provider discovers credible evidence of fraud, they are required to notify the appropriate authorities within a prescribed timeframe. This standard is put in place to ensure that potential misconduct is reported promptly, allowing for timely investigation and mitigation. The 60-day requirement is meant to strike a balance between giving organizations enough time to gather and assess evidence while also ensuring that fraud is reported swiftly to protect the integrity of healthcare programs.

The options of 30 days, 45 days, and 90 days do not align with the established regulations and guidelines regarding the reporting of fraud. This clearly emphasizes the importance of understanding the complete context and requirements surrounding compliance and reporting in healthcare finance and administration.