• (303) 876-0575

Law Offices of Elizabeth “Booka” Smith, LLC Blog

.

September 15, 2015: Settlement discussions afoot in S.D.N.Y. FCA Qui Tam lawsuit over failure to repay Medicaid overpayments within 60 Days

In 2011, Robert Kane, a former employee of Continuum Health
Partners, Inc., filed an FCA qui tam lawsuit under seal in the Federal District Court for the Southern District Court of New York alleging that he was fired after he internally reported
Conituum’s failure to reimburse the government for Medicaid overpayments within
60 days as required by the Affordable Health Care Act. As a Relator, Kane named
other entities, including Healthfirst, Inc., a non-profit insurance program
which caused a network of New York City non-profit hospitals operated and
coordinated by Continuum to submit improper Medicaid claims for payment to the
government. The DOJ investigated the allegations, and the case was unsealed in
June of 2014 when the DOJ intervened. On August 3, 2015, Judge Ramos of the
S.D.N.Y. denied the defendants’ motion to dismiss the lawsuit, finding that as
soon as the defendants were put on notice of the possible overpayments, the 60 day
ACA clock started ticking. Judge Ramos ruled that the defendants will need to
present solid proof of good-faith efforts to investigate and address the
problem in order to avoid FCA liability. The DOJ is seeking treble damages,
penalties of $11,000 for each overpayment retained beyond the 60 days, and
costs of suit. The total damages could well exceed $100M. On September 15,
2015, the DOJ notified Judge Ramos that serious settlement discussions in the
case were underway. As a Relator, Kane stands to recover a substantial portion
of any settlement. The Law Offices of
Elizabeth “Booka” Smith, LLC investigates potential FCA qui tam lawsuits and advises potential relators how to present
their case to the DOJ such that the DOJ will opt to intervene, thereby
maximizing the likelihood of success for the relator. If you have information
that a company is in violation of the FCA for defrauding the government and are
considering becoming a relator in a potential qui tam lawsuit, CONTACT US to schedule an initial consultation and
to evaluate potential representation.

October 14, 2015: ACC Census data suggests that Fe...
September 10, 2015: Second Circuit Agrees with the...

By accepting you will be accessing a service provided by a third-party external to https://www.bookalaw.com/

Downtown:
1624 Market Street, Suite 202
Denver, CO, 80202

Tel (303) 876-0575
Silverthorne:
56 Road L, P.O. Box 601
Silverthorne, CO, 80498

Tel (303) 876-0575

Additional offices for meetings available in:
Boulder; Broomfield/Interlocken; Cherry Creek; Aurora; Downtown Denver; Denver Tech Center; Golden/ Lakewood; Littleton; Louisville and Park Meadows/Highlands Ranch

Disclaimer: Nothing in this website is intended in any way to form an attorney-client relationship or other contract. It is designed solely to provide general information about the practice at the Law Offices of Elizabeth “Booka” Smith. Be mindful of any deadlines you have approaching that relate to your legal situation, and make sure you meet them. The Law Offices of Elizabeth “Booka” Smith does not assume any responsibility for advice given regarding any aspect of your case until you have a signed legal services agreement engaging the firm’s representation. Though the Law Offices of Elizabeth “Booka” Smith may provide a free initial consultation, the firm retains complete discretion in every case to decide whether or not to take your case. The Law Offices of Elizabeth “Booka” Smith makes no guarantees, warranties, or predictions about your case, and past success of Booka Smith or the firm does not ensure the results will be the same.