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Showing 1 post in United States ex. Rel. Kane v. Continuum Health Partners.

DOJ Intervenes In Case Involving ACA’s 60-Day Overpayment Rule

Posted In Affordable Care Act, Audit, Health Care Law, Health Insurance, Medicaid, Overpayments, United States ex. Rel. Kane v. Continuum Health Partners

Recently, the Department of Justice (“DOJ”) intervened in a qui tam whistleblower suit in the US District Court for the Southern District of new York, which involves Continuum Health Partners and several Mount Sinai-related hospitals. United States ex. Rel. Kane v. Continuum Health Partners, Inc. et al, (Civil Action, No. 11-2325(ER)). While DOJ intervention in whistleblower cases is not unusual, this case is significant because the DOJ’s complaint specifically alleges that the defendants failed to return Medicaid overpayments within 60 days, as required by the Affordable Care Act (“ACA”). The case is one of the first to explore the issues and interpret the requirements of the 60-Day Rule. More >

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