In a legal decision handed down last week by the Washington, D.C. Circuit Court of Appeals, UnitedHealth and other private payers administering Medicare Advantage (MA) plans were ordered to return overpayments – despite receiving incorrect diagnoses from providers submitting claims.

The decision is likely to have serious ramifications, to the tune of tens of billions of dollars. It’s been estimated that such MA overpayments in 2016 soared to more than $16 billion.

The bad news is that private payers like UnitedHealth must return overpayments. The good news is a possible payday for providers who surrendered billions of dollars to private payers.

Reporting our lead story during the next edition of Monitor Mondays will be prominent healthcare attorney Andrew Wachler, managing partner in the law firm of Wachler and Associates.

To learn more about the details of this recent ruling and its implications for providers (and payers), listen to the next live edition of the weekly Internet radio broadcast, coming your way on Monday, Aug. 23 at 10 a.m. EST.

Other segments to be featured during the live broadcast include the following:

• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will return with another installment of his popular segment.
• RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Practus, will file the Monitor Mondays RAC Report.
• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment, reporting on legal implications facing healthcare providers.
• SDoH Report: Ellen Fink-Samnick,anationally recognized expert on the social determinants of health (SDoH), will have the latest news on a trending topic that is attracting significant media attention. Ellen will also conduct the Monitor Mondays Listeners Survey.