Judge: Employee’s Report Constitutes ‘Identified’ Overpayments Under ACA

Mealey's (August 6, 2015, 12:40 PM EDT) -- NEW YORK — An employee’s report sufficiently identified $1 million in potential overpayments from Medicaid, triggering the Patient Protection and Affordable Care Act (ACA)’s 60-day reporting and return mandate, a federal judge in New York held Aug. 3 (Robert P. Kane, et al. v. Healthfirst Inc., et al., State of New York and United States of America v. Continuum Health, No. 11-2325, S.D. N.Y.).

(Opinion available. Document #93-150819-010Z.)

Continuum Health Partners employee Robert Kane identified what he believed were 900 claims in which a computer glitch...
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