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Legal & Regulatory Issues

Contrary to popular belief, reducing nonurgent visits to the emergency department — or visits deemed inappropriate for the ED — may not produce cost savings, according to a study in Annals of Emergency Medicine (pdf).

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The Patient Protection and Affordable Care Act might conjure up notions of individual mandates, health exchanges or Medicaid expansion, but there's much more to the law than its hot-button provisions.

HHS and CMS have issued the final rule on new standards for electronic funds transfer and electronic healthcare claims attachments, which establish how healthcare providers can use electronic systems to determine a patient's eligibility for health coverage and check on…

Medicare billing practices at Vanderbilt University Medical Center in Nashville are the subject of a probe by the U.S. Department of Justice and Office of Inspector General, according to a Tennessean report.

FBI and state investigators seized medical files from the mental clinic at Riverside General Hospital in Houston yesterday, four months after an RGH executive was arrested for his role in a $116 million Medicare fraud scheme, according to a Houston…

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