Articles and Blogs

60-day Rule

Court Vacates 60-Day Rule for Medicare Advantage Plans, Creates Uncertainty for Same Rule Applicable to Medicare-Enrolled Providers

[09/17/18]

Posted on September 17, 2018 in Health Law News

Published by: Hall Render

Nearly a decade has passed since the U.S. Congress enacted the Patient Protection and Affordable Care Act (the “ACA”). Since March 2010, we have seen federal court rulings on numerous challenges to the ACA itself and the executive branch’s efforts to enforce the ACA. One such challenge resulted on September 7, 2018 in the... READ MORE

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A Horse for a Different Course: Fourth Circuit Declines to Apply 60-Day Rule to Medicare Secondary Payer Act

[06/18/18]

Posted on June 18, 2018 in False Claims Act Defense

Published by: Hall Render

Most health care providers caring for federal health care program beneficiaries are familiar with the False Claims Act[1] (“FCA”) and its qui tam provision,[2] which grants private citizens the right to sue health care providers on behalf of the federal government. The seemingly routine 6+ figure FCA settlements garner much-deserved attention. After all, providers... READ MORE

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DOJ Intervenes in Retained Overpayment Suit

[06/30/14]

Posted on June 30, 2014 in False Claims Act Defense

Written by: Drew B. Howk

With the passing of the Affordable Care Act (“ACA”), False Claims Act (“FCA”) observers noted the imminent filing of cases alleging violations of the ACA’s amendments to the FCA or “reverse” false claims. Such claims are per se false claims under the FCA and arise when a government contractor or health care provider becomes aware... READ MORE

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