Division of Administrative Hearings, Florida
Filed: Jul. 13, 2015
The issue for determination is whether an amount of up to $46,901.85, which Petitioner paid on behalf of eligible aliens for emergency hospital inpatient services that Respondent provided during the period from January 1, 2007, to December 31, 2007, constitutes an overpayment that Respondent must return, on the grounds that the services are not covered by Medicaid, despite having been included in claims of Respondent's that were prior authorized by Petitioner before payment.Sums paid on behalf of eligible aliens for emergency services provided by Respondent did not constitute an overpayment because the services were covered by Medicaid, as Petitioner had determined originally when it gave prior authorization to the claims.
