Legal & Regulatory Issues

This past August, the U.S. Department of Justice sent guidelines to hospitals that dealt with the medical necessity of implantable cardioverter defibrillators, or ICDs.

Duluth, Minn.-based Essentia Health said is has refunded $865,000 in Medicare overpayments after an audit found more than $1.2 million is overbillings, according to The Sacramento Bee.

The American Hospital Association released a letter this week to the departments of Health and Human Services and Justice fighting back against the departments' allegations that electronic health records may be used for upcoding, according to AHANews.

The Federal Trade Commission should consider indicators of a hospital's future ability to operate when conducting regulatory reviews of mergers and acquisitions, according to an amicus brief filed by the American Hospital Association.

The Michigan legislature has rejected a measure to allow Flint, Mich.-based McLaren Health Care to build a new $300 million hospital without a certificate of need, according to a Detroit News report.

Valley Hospital in Ridgewood, N.J., and Englewood (N.J.) Hospital and Medical Center have again turned to the courts to try to stop Hackensack (N.J.) University Medical Center from opening Pascack Valley Hospital in Westwood, N.J., according to a Record report.

A lawsuit previously filed by two former employees of Pleasant Valley Hospital in Point Pleasant, W.Va., claiming they were fired based upon their sexual orientation, is still active and will go to the fifth judicial circuit court, according to a…

HHS Secretary Kathleen Sebelius and U.S. Attorney General Eric Holder sent a letter (pdf) to the five major hospital associations saying the federal government "will not tolerate healthcare fraud," and law enforcement agencies will pursue providers who try to "game…

The federal government is ramping up its efforts to combat healthcare fraud, and if the government targets your hospital for an investigation, it's critical the hospital has a strong reputation and community support to weather this challenging period, according to…

The U.S. Department of Justice and Massachusetts Attorney General Martha Coakley are closely scrutinizing Boston-based Partners HealthCare System's bid to acquire South Shore Hospital in Weymouth, Mass., according to a Boston Globe report.