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Overpayment Department of Health and Human Services (HHS) Healthcare

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | March 2025 Recap

McDermott Will & Emery on

This issue of McDermott’s Healthcare Regulatory Check-Up highlights key regulatory and enforcement activity for March 2025. This month features: - Noteworthy enforcement actions demonstrating that the Anti-Kickback Statute...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 31, Number 43. News Briefs: December 2022

HealthOne Critical Care Transport Service Inc., doing business as MedicOne Medical Response of Marion, Illinois, has agreed to pay $302,124 to settle allegations it improperly billed Medicare for scheduled, non-emergency...more

Epstein Becker & Green

CMS Wins on Partial Appeal—D.C. Circuit Court Rules Against United’s Initially Successful Challenge to the Medicare Part C...

Epstein Becker & Green on

On August 13, 2021, the U.S. Court of Appeals for the District of Columbia Circuit (“D.C. Circuit”), in a much-anticipated decision, unanimously reversed rulings by the U.S. District Court for the District of Columbia...more

Baker Donelson

OIG Hospital Compliance Audits: Is Your Number Up? Are You Ready?

Baker Donelson on

In its Work Plan for Fiscal Year 2012, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) announced it would begin reviews of Medicare payments to hospitals to determine compliance...more

Cadwalader, Wickersham & Taft LLP

In Closely Watched Case, Federal Court Upholds the Government’s Position on Provider Mandate to Report and Return Medicare and...

The Patient Protection and Affordable Care Act (“PPACA”), signed into law on March 23, 2010, included a provision (the “Report and Refund Mandate”), broadly requiring health care providers, suppliers, Part D plans and managed...more

Polsinelli

SDNY Issues Groundbreaking Decision On False Claims Act Sixty-Day Rule

Polsinelli on

Medicare and Medicaid providers have an obligation to refund overpayments from federal health care programs. The False Claims Act (“FCA”) imposes liability for any person who “knowingly conceals or knowingly and improperly...more

McDermott Will & Emery

OIG Proposes Rule to Expand Civil Monetary Penalties and Solicit Comments on Penalty for Failure to Report and Return Overpayments...

McDermott Will & Emery on

Department of Health and Human Services, Office of Inspector General’s (OIG) proposed rule expands the use of civil monetary penalties and solicits comments on the penalty for failure to report and return overpayments. ...more

BakerHostetler

Recent OIG Report Underscores Need for Home Health Agencies and Physicians to Comply With Medicare’s Face-to-Face Documentation...

BakerHostetler on

Medicare overpaid the home health industry $2 billion between January 2011 and December 2012, according to a recent report by the U.S. Department of Health and Human Services, Office of Inspector General (OIG). The OIG’s...more

King & Spalding

Third Circuit Holds Judicial Review of Extrapolated Overpayment Determinations is Precluded

King & Spalding on

On February 12, 2014, the U.S. Court of Appeals for the Third Circuit held that Federal courts do not have jurisdiction to review HHS’s determination of a “sustained or high level of payment error,” one of two possible...more

BakerHostetler

American Taxpayer Relief Act Amends Overpayment Recovery Time Limits

BakerHostetler on

The ATRA significantly alters provider rights related to overpayment recoupment, refunds, audits and claims appeals. A provision entitled "Removing obstacles to collection of overpayments" increases the statute of limitations...more

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