On October 13, 2017, a Jacksonville cardiovascular practice entered into an approximately $440,000 settlement to resolve allegations concerning violations of 42 U.S.C. 1320a-7k (the 60-Day Overpayment Rule) and its Florida state law analogue. The settlement reflects the enforcement community’s increasing focus on the 60-Day Overpayment Rule.

The medical group allegedly failed to have a process in place to investigate and refund credit balances, which resulted in an overpayment from Federal healthcare programs of approximately $175,000, less than half of the settlement amount.

Notably, the recently unsealed qui tam focuses solely on the retention of overpayments. The complaint does not allege the submission of false claims in the first instance and recognizes that many credit balances result from innocent conduct by a provider.

To view the DOJ press release, click here. To view the complaint, click here