Modern Healthcare Consults White Collar Principal John Joseph on District Court's Medicare/Medicaid Overpayment Decision and Impact on Providers
In the August 4 article, "Decision in 60-day repayment rule case puts providers on alert," Modern Healthcare examines a decision by U.S. District Judge Edgardo Ramos in Kane v. Healthfirst Inc. et al. and U.S. v. Continuum Health Partners Inc. et al., that rejected a healthcare provider's request to dismiss a government case against it. The case alleged that the provider, "failed to return Medicare and Medicaid overpayments within 60 days." The provider had "argued that the 60-day countdown shouldn't start until a provider is sure there is an overpayment."
Mr. Joseph explains the potential impact of the decision:
"If a hospital, in good faith, tries to determine whether something is an overpayment or not and takes more than 60 days to do it … they could potentially be held liable. If they have information that suggests there's a potential overpayment, that is not something they can wait to act on.”