News & Analysis as of

Overpayment Motion to Dismiss

Proskauer - Employee Benefits & Executive...

District Court Rejects Participant’s Attempt to Stop Plan From Recouping Overpayments

In Kanefsky v. Ford Motor Co. Gen. Ret. Plan, No. 22-cv-2259, 10548 U.S. Dist. 2023 WL 186800 (E.D. Mich. Jan. 13, 2023), the court granted a motion to dismiss a pension plan participant’s claim that the plan was equitably...more

King & Spalding

Home Health Agency Unable to Block HHS From Recouping $2.8 Million in Alleged Overpayments

King & Spalding on

An Arizona District Court judge held last week that the court lacked subject-matter jurisdiction over a home health agency’s (HHA) procedural due process claim because the HHA had failed to present its claim to HHS first and...more

King & Spalding

Massachusetts District Court Allows FCA Lawsuit Alleging Hospital Overbilled for Double-Booked Surgeries Performed Without...

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On June 17, 2019, the U.S. District Court of the District of Massachusetts rejected Massachusetts General Hospital’s (MGH) request to dismiss a qui tam complaint alleging that the teaching hospital fraudulently overbilled...more

Cadwalader, Wickersham & Taft LLP

Delaware Chancery Court Finds Absence of Controlling Stockholder Does Not Eliminate Possibility for Adequately Pled Corporate...

On July 26, 2018, Vice Chancellor Glasscock of the Delaware Court of Chancery denied in part and granted in part Defendants’ motion to dismiss in Sciabacucchi v. Charter Communications Corporation et al....more

Holland & Knight LLP

Ruling: Medical Providers Not Subject to Double Damages Under Medicare Secondary Payer Act

Holland & Knight LLP on

• In a matter of first impression, the U.S. District Court for the Middle District of Florida has ruled that a private right of action under the Medicare Secondary Payer Act (MSP Act), which provides for double damages in the...more

Jones Day

Sixth Circuit: Technical Physician Signature Deficiencies not "Material" to Reimbursement Claims

Jones Day on

The District Court for the Middle District of Tennessee held on June 22, 2017, that the timing requirements related to a physician's certification of need for home health services were not "material" to the Centers for...more

King & Spalding

Tax Litigation Update – Fall 2016

King & Spalding on

Tax Court Denies Commissioner’s Motion to Compel After Predictive Coding Used to Identify Responsive Documents - On July 13, 2016, Judge Ronald Buch of the Tax Court denied the Commissioner’s motion to compel Dynamo...more

Lowndes

Recent Cases Involving 60-Day Overpayment Rule Should Put Healthcare Providers on Alert

Lowndes on

Two recent federal court cases show that the federal government intends to vigorously enforce the so-called “60-day Rule” for the return of overpayments enacted as part of the Affordable Care Act (the “ACA”) even though the...more

Ballard Spahr LLP

The 60 Day Rule — Identification and Knowing Avoidance

Ballard Spahr LLP on

On August 3, 2015, the United States District Court for the Southern District of New York issued an opinion and order in Kane v. Healthfirst, Inc., et al.[1] that provides the first judicial interpretation of the requirement...more

Baker Donelson

District Court Issues First Decision Interpreting ACA's 60-day Rule

Baker Donelson on

The first case to interpret when the clock begins to run on the “60-Day Rule” did not go well for health care providers. On August 3rd, the Southern District of New York rejected defendants HealthFirst, Inc.’s and Continuum...more

Bradley Arant Boult Cummings LLP

When an Overpayment Becomes a False Claims Act Issue: Explaining the First Judicial Interpretation of the 60-Day Rule

On August 3, 2015, Judge Edgardo Ramos of the United States District Court for the Southern District of New York issued the first judicial opinion addressing when a health care provider has “identified” a Medicare or Medicaid...more

Cozen O'Connor

Ignorance Is Not Bliss: The 60-Day Clock under the ACA’s “Return and Report Rule” Can Start Ticking Well Before the Exact Amount...

Cozen O'Connor on

On August 3, 2015, a federal judge in the Southern District of New York ruled that the United States’ and state of New York’s complaints in intervention can move forward against a group of hospitals, under the federal False...more

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