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.