In a case dating back several years, the first judicial opinion interpreting the Affordable Care Act’s “60-Day Overpayment Rule” in a False Claims Act case was recently issued by the Southern District of New York. In Kane v. Healthfirst, Inc., et al., the court found in favor of the DOJ, denying the defendant hospitals’ motion to dismiss, finding that the hospital had failed to timely repay overpayments. Although providers are still awaiting CMS’ Final Rule (the proposed rule was covered on our Health Industry Washington Watch blog back in 2012 here), after this recent decision, questions remain regarding how its holding will apply to providers who diligently investigate potential overpayments but fail to meet the 60-day reporting and repayment timeframe.

For more details on this decision and the potential impact to providers, read the Client Alert written by Carol Loepere, Scot Hasselman and Nancy Bonifant.