Clawing Back Overpayments From Health Care Providers

Law360, New York (November 14, 2011, 3:54 PM EST) -- A medical plan’s board of trustees may proceed with its restitution claim against health care providers to collect expenses the plan paid for the treatment of plan members that were later determined to have been either excessive or excluded as not medically necessary, the U.S. District Court for the Northern District of California ruled on Sept. 12, 2011. (International Longshore & Warehouse Union-Pacific Maritime Ass’n Welfare Plan Board of Trustees v. South Gate Ambulatory Surgery Center, No. 11-01215-WHA (N.D. Cal. 9/12/11).

In South Gate, Employee Retirement...
To view the full article, register now.