PRRB Dec. No. 2020-D15

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Decision Number
PRRB Dec. No. 2020-D15
Case Name
Innovis Hospital d/b/a Essentia Health Fargo vs. Noridian Healthcare Solutions, LLC
Issue
Whether the MAC’s adjustment to reconcile outlier payments was proper and, since the MAC waited 5 years after discovering the error before notifying the Provider, whether the law bars recovery of the overpayment.