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Primary Care Providers Win Challenge of CMS Interpretation of Enhanced Payment Law

With the help and support of the Tennessee Medical Association, 21 Tennessee physicians of underserved communities joined together and retained Bass, Berry & Sims to file suit against the Centers for Medicare & Medicaid Services to stop improper collection efforts. Our team, led by David King, was successful in halting efforts to recoup TennCare payments that were used legitimately to expand services in communities that needed them. Read more

Tennessee Medical Association & Bass, Berry & Sims

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Thought Leadership

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Thought Leadership Spotlight

Healthcare Transactions: Year in Review 2018Last year, CVS Health Corp. (NYSE: CVS) announced it would purchase health insurer Aetna Inc. (NYSE: AET) for $67.5 billion, a transaction that would be one of the biggest healthcare mergers in the past decade. The transaction raises an intriguing question: is this the beginning of a transformational shift in healthcare?

Recently, members of our healthcare group authored the Healthcare Transactions: Year in Review outlining 2017 M&A activity and drivers in the following hot healthcare sectors:

• Managed Care
• Hospitals
• Post-Acute Care—Home Health & Hospice
• Ambulatory Surgery Centers (ASCs)
• Healthcare Information Technology (HIT)
• Behavioral Health
• Physician Practice Management

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Attorneys Examine Court Rulings on Refunds of Overpayments Under FCA

ABA's Section of Litigation, Health Law Litigation Article

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February 1, 2016

Bass, Berry & Sims attorneys Anna Grizzle, Brian Roark and Julia Tamulis authored an article for the American Bar Association (ABA) examining two recent rulings that provide direction to healthcare providers related to the timing of refunds of overpayments as defined under Section 6402(d) of the Patient Protection and Affordable Care Act (PPACA). Under the PPACA, a provider has 60 days to refund the overpayment once the discrepancy is identified or risk liability under the False Claims Act (FCA). These cases mark the first time healthcare providers have received any guidance of its repayment obligations required under PPACA. In the article, the authors outline the decision in United States ex rel. Kane v. Healthfirst, Inc. and the settlement in United States ex rel. Odumosu & Mccray v. Pediatric Services of America Healthcare that provide guidance on this issue. 

The full article, "On the Clock: Failure to Timely Refund Overpayments Leads to FCA Exposure," was published by the ABA's Section of Litigation, Health Law Litigation and is available online.


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