Compliance News Roundup: Reverse False Claims

1. Manhattan U.S. Attorney Announces $2.95 Million Settlement With Hospital Group For Improperly Delaying Repayment Of Medicaid Funds - ”Manhattan U.S. Attorney Preet Bharara said: 'When Continuum learned that it had received over $800,000 in potential overpayments from Medicaid in 2011, it had an obligation under the law to return those funds within 60 days. Instead, Continuum delayed repayment for more than two years and only fully repaid the Medicaid program in 2013. With this settlement, Continuum has made admissions and is paying $2.95 million for its fraud on Medicaid:'" https://www.justice.gov/usao-sdny/pr/manhattan-us-attorney-announces-295-million-settlement-hospital-group-improperly

2. Mt. Sinai Says Effort To Identify Overpayment Was Complicated - "DOJ says health system 'willfully' delayed repaying $844,000 in Medicaid overpayments. Mt. Sinai says its 'good faith' effort to identify the overpayment in 2011 was 'time consuming and complicated:'" http://www.healthleadersmedia.com/leadership/mt-sinai-health-settles-295m-medicaid-fraud-suit

3. Deeper Than The Headlines: $2.95 million settlement for “reverse false claims” - “The significance of the case originates from the judge’s ruling on when the clock starts ticking, so to speak, as it relates to the 60-day time limit for refunding overpayments. When is an overpayment considered to be “identified?” In this particular case, it was determined the email sent by Kane to upper management which included the spreadsheet of overpayments was determined to be the point when the 60-day clock began to tick. Even though the email and spreadsheet did not conclusively close the investigation of potential overpayments:" Deeper Than the Headlines: Reverse False Claims