Insights
Barbara Rowland and Elizabeth Hein Examine Medicare Advantage Litigation and Impact on 60-Day Rule for ABA Health Lawyer
In the June 2018 issue of the American Bar Association's (ABA) Health Lawyer magazine, Barbara Rowland and Elizabeth M. Hein co-authored the article, "Medicare Advantage Plan Litigation Challenges CMS Interpretation of 60-Day Overpayment Rule." The article examines the issues surrounding how the 60-Day Overpayment Rule (60-Day Rule) is applied to Medicare and Medicaid and how the current structure may trigger False Claims Act (FCA) exposure. The article also provides analysis of the must-watch, ongoing federal litigation brought by United Healthcare Insurance Company’s (UHC) Part C plans against the United States to square agency rulemaking imposing a negligence standard for addressing overpayments on Medicare Part C and D providers with the False Claims Act's stricter “knowledge” requirement.
The article, "sets out the battle lines between UHC and the government in the declaratory injunction case...and also briefly addresses the issue overlap with two FCA cases brought by the U.S. Department of Justice... in the Central District of California."