A federal adjudicator denied Sunrise, Fla.-based Mednax’s motion to aish Aetna’s accusation alleging the medical accumulation aggrandized bills for neonatal care.
Aetna commenced acknowledged activity in the Philadelphia Court of Common Pleas in November 2017 by filing a praecipe to affair a command of amendment on Mednax and dozens of its affiliates. In a accusation filed in April, Aetna accused Mednax of exaggerating the severity of newborns’ analytic altitude and acclimation accidental tests to aerate bills, ultimately overbilling the insurer $50 million. The “upcoding” arrangement allegedly began in 2009 and connected through at atomic September 2016.
Mednax filed a motion to aish the case, arguing that Aetna’s claims fell alfresco of the two-year statute of limitations. Aetna argued its claims are adapted beneath the continuing violations article and the assay rule, according to The Acknowledged Intelligencer.
On Oct. 23, U.S. District Adjudicator Wendy Beetlestone of the Eastern District of Pennsylvania denied Mednax’s motion to dismiss.
“This clothing was accomplished in November 2017 — accordingly, any blameworthy acts that took abode in 2016 abatement aural the two-year limitations period,” Ms. Beetlestone said. “Nevertheless, because Aetna has declared an advancing arrangement that persisted into the limitations period, it is not adapted to dness at the pleadings date whether the continuing violations article allows Aetna to advance clothing for accomplishments that occurred above-mentioned to the limitations period. Further, because Mednax allegedly buried the canard of its claims, it is accessible that the assay aphorism applies as well.”
Ms. Beetlestone additionally captivated that Aetna presented issues of actuality in its complaint that charge to be explored further.
“It may be shown, as Mednax asserts, that Aetna had admission to assertive abstracts apropos Mednax’s claims, and that Aetna generally investigates claims or denies advantage in such a way as to cede its assurance on Mednax’s forms unjustifiable,” Ms. Beetlestone said. “But that catechism turns on issues of actuality —such as Aetna’s admission to affidavit basal anniversary affirmation — and is not appropriately bound on a motion to dismiss.”
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