American Journal of Law & Medicine

Administrative law: statute restricting judicial review of medicare reimbursement decisions applies to actions brought by the United States.(Select Recent Court Decisions)

Administrative Law: Statute Restricting Judicial Review of Medicare Reimbursement Decisions Applies to Actions Brought by the United States--United States v. University of Massachusetts Memorial Medical Center (1)--On an issue of first impression, the Federal District Court for the District of Massachusetts held that the Medicare Act (2) restricted judicial review of Medicare reimbursement decisions brought by the United States. (3) The case revolved around a nationwide investigation of Medicare billing practices conducted by the Department of Justice. This investigation revealed that the University of Massachusetts Memorial Medical Center ("UMass Medical") improperly received overpayments for Medicare reimbursement claims submitted to the Department of Health and Human Services ("HHS"), due to a misinterpretation of the Medicare regulations. Acting on this information, the United States brought suit against UMass Medical to recover these payments. …

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