C&M Health Law

C&M Health Law

Analysis, commentary, and the latest developments in health care law and policy

Diana Huang

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Trump Administration Rejects (Nicely) Idaho’s Attempt to Skirt ACA

Posted in Exchanges, Health Care Reform & ACA
On Thursday, March 8, the Trump Administration rejected Idaho’s plan to sell health plans that do not include the consumer protections required by the Affordable Care Act (ACA). The rejection came in the form of a letter touting adherence to current law, though in many ways the letter was written by an apologetic Centers for… Continue Reading

Mount Sinai Health System to Pay $2.95 Million in 60-Day Overpayment FCA Settlement

Posted in Fraud, Waste & Abuse, Health Care Reform & ACA, Litigation
On August 24, 2016, Judge Edgardo Ramos of the Southern District of New York approved a settlement in which Mount Sinai Health System (Mount Sinai) will pay $2.95 million to New York and the federal government to resolve allegations that it violated the False Claims Act (FCA) by withholding Medicare and Medicaid overpayments in contravention… Continue Reading

S.D.N.Y. Provides First Judicial Guidance on Identifying Overpayments and Effect on FCA Liability

Posted in Fraud, Waste & Abuse, Health Care Reform & ACA, Litigation
On August 3, 2015, in Kane v. Healthfirst, Inc., No. 1:11-cv-02325-ER (S.D.N.Y. Aug. 3, 2015), Judge Edgardo Ramos of the Southern District of New York decided an issue of first impression under the False Claims Act (FCA) requirement to return identified overpayments from Medicare and Medicaid within sixty (60) days. In denying the defendants’ motion… Continue Reading