Six common algorithms for commercial claims spur more than $122 million in overpayments each year, suggesting an ample amount of wasteful and potentially fraudulent healthcare spending in the commercial sector, according to a new analysis from Truven Health Analytics.
Legal & Regulatory Issues
A nearly year-long search for Paul Cardwell, the former CEO of Powell (Wyo.) Valley Healthcare, came to an end last Friday when he was arrested in Thailand, according to a Powell Tribune report.
University of Pittsburgh Medical Center has filed an amended lawsuit against city Mayor Luke Ravenstahl, claiming the mayor's lawsuit challenging UPMC's nonprofit status is a strategy to divert attention from a city scandal, according to a copy of the lawsuit.
CMS has revoked 14,663 providers' ability to participate in Medicare since March 2011 due to fraud control efforts.
A former cardiologist at St. Joseph's Hospital in London, Ky., has pleaded guilty to charges of implanting unnecessary stents in patients' hearts, according to a Courier-Journal report.
Advertisement
A neurologist has filed suit against Salt Lake City-based Intermountain Healthcare for allegedly causing the closure of her clinic and risking stroke patients' health to increase revenue for its emergency departments, according to a Salt Lake City Tribune report.
South Bend, Ind.-based Beacon Health System is one of five institutions facing a sex discrimination complaint from the National Women's Law Center, which has requested an investigation into the system's health benefits plan and pregnancy coverage, according to a South…
Two plaintiffs have filed a lawsuit in Cook County Circuit Court in Chicago, asking the court to strike a new law that defines charity care for tax-exempt hospitals in Illinois, according to an Associated Press/Tribune report.
In April, the Office of Inspector General of the HHS issued an updated provider self-disclosure protocol, revised from the SDP published in 1998. The updated protocol instructs healthcare providers on what to do if they discover actions violate federal fraud…
A former administrator at University Medical Center in Lubbock, Texas, is facing charges of federal mail fraud after he stepped down 18 months ago during an FBI investigation, according to an Amarillo Globe-News report.