When is an Overpayment Identified?

The Affordable Care Act (“ACA”) amended the False Claims Act (FCA) “reverse false claims” provision to include an obligation that providers report and return any overpayment within 60 days of identification.  However, the ACA did not define identification which has caused considerable confusion among health care providers. In the recent whistleblower/false claims case of Kane v. Healthfirst, Inc., a federal district court judge has defined the term very narrowly, to mean that the overpayment is identified when the provider is… Read More >