INSIGHT: Health-Care Providers Are Pushing Back on Medicare Clawbacks

Kent Hofmann, a Commercial Litigation Partner in Locke Lord’s Austin office, authored an article for Bloomberg Law’s Health Law & Business section detailing a series of recent opinions and orders where Medicare providers have succeeded in obtaining injunctive relief to prevent recoupment of their Medicare revenues while prosecuting appeals of overpayment demands by the Centers for Medicare & Medicaid Services. Hofmann examines the process to challenge a Medicare overpayment demand, including a four-stage administrative appeals process before judicial relief.

Ultimately, Hofmann concludes, “A provider has a reasonable opportunity to obtain injunctive relief against recoupment, particularly in the federal Fourth and Fifth Circuits, while it prosecutes its administrative appeal of an overpayment demand, if it pleads the claims addressed by the Fifth Circuit in Family Rehabilitation and makes a strong showing of irreparable and imminent harm as a result of the ongoing recoupment.”

To read the full article, click here. Posted with permission from Bloomberg Law.