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State Net Capitol Journal: Health Exchange Enrollments Lag In First Month

Only three states — Connecticut, Rhode Island and New York — reached their enrollment targets in the first month of open enrollment in the health insurance exchanges created under the Affordable Care Act. All three states, which run their own exchanges, actually exceeded their targets, with...

Cadwalader: Federal Court Upholds Provider Mandate to Report and Return Medicare and Medicaid Overpayments in 60 Days

Introduction | The Patient Protection and Affordable Care Act (“PPACA”), signed into law on March 23, 2010, included a provision (the “Report and Refund Mandate”), broadly requiring health care providers, suppliers, Part D plans and managed care organizations that were overpaid...

Barnes & Thornburg: DOJ Secures Big Win in First Court Interpretation of FCA’s 60-Day Overpayment Rule

By Jessica Talati On August 3, Judge Edgardo Ramos of the Southern District of New York denied hospital defendants’ motions to dismiss in United States ex rel. Kane v. Healthfirst, Inc., et al . , No. 11 CIV 2325 (S.D.N.Y. Aug. 3, 2015), keeping alive a much-followed whistleblower case accusing...

Williams Mullen: The Definition of Identify: The 60-Day Rule

By Ruth Levy & Patrick C. Devine, Jr. | The Patient Protection and Affordable Care Act (“PPACA”) established that any person who receives an overpayment from the Medicare or Medicaid programs and who does not report and return the overpayment within 60 days after it is identified will...

Keller and Heckman LLP: Debate Over NYC Sodium Menu Labeling Gets Salty

On Sept. 9, 2015, the New York City Board of Health unanimously passed regulations making New York the first U.S. city to require restaurants to disclose to diners those menu items that contain more than 2,300 milligrams of sodium, or the equivalent of about one teaspoon of salt. Under the newly-adopted...