A win for efficiency: The AHA suit may force shorter adjudication times for Medicare administrative appeals. In 2014, the American Hospital Association (AHA), along with three hospital systems, filed suit against the U.S. Department of Health and Human services, alleging that the lengthy adjudication time for administrative appeals of Medicare claim denials caused severe economic … Continue Reading
Under the Affordable Care Act (ACA), healthcare providers that receive an overpayment from Medicare or Medicaid are required to report and return the overpayment to the government within 60 days after the date on which the overpayment was identified (commonly referred to as the “60-day rule”). An overpayment retained after 60 days constitutes an “obligation” … Continue Reading
The fascinating interplay that weaves between the First and Fifth Amendments to the U.S. Constitution, the Religious Freedom Restoration Act (RFRA) and the Patient Protection and Affordable Care Act (ACA) continues to march on in various jurisdictions around the country, with two recent examples being the United States Supreme Court’s grant of certiorari and remand … Continue Reading
