Contract provisions prevail when terms are clear for recoupment.

Topic: Care Management Organization, Decided by Judge Schroer 
Docket Number: 1325889 , Decision Date: 2013-07-29 
Attachment: Click here to download the decision. 

Where a contract provides for two methods of payment, the Care Management Organization is permitted to compensate the hospital at the lower rate and recoup payments made at the higher rate as erroneous.


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