The fight against healthcare fraud is a top priority for the government today, as evidenced by harsher federal sentencing guidelines for healthcare fraud, an increase in the number of Medicare Fraud Strike Force teams and federal fraud prevention programs such…
Legal & Regulatory Issues
It's been more than a month since the Supreme Court upheld the Patient Protection and Affordable Care Act, yet Justice Antonin Scalia, one of the judges who dissented in the 5-4 vote to uphold it, continues to criticize the ruling,…
Maine will have to repay roughly $9.2 million to the federal government after the Office of Inspector General (pdf) found that the state's Medicaid agency incorrectly processed claim adjustments.
An investigation of the Maryland Board of Physicians found that the professional body should have its duties and powers outlined by the state General Assembly and recommended it be split into two panels — one for investigations and one for…
President Barack Obama is planning to partner with dozens of private payors to share claims data and better coordinate the fight against healthcare fraud, according to a New York Times report.
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A new Senate Committee report reveals that nearly 70 percent of drugs in short supply are leaked to distributors through pharmacies. The distributors, in turn, offer to sell the drugs to hospitals for prices that are "often hundreds of times…
Massachusetts Gov. Deval Patrick has proposed a new plan to determine whether large providers are abusing their market power by hiking up fees, according to a Boston Globe report.
CMS has hired Figliozzi & Company of Garden City, N.Y., to perform the promised audits of Medicare providers and dual-eligible Medicare and Medicaid hospitals that have received federal electronic health record system incentive payments.
Repealing the Patient Protection and Affordable Care Act — a top priority for many Republican lawmakers — would cause a net increase in the federal budget deficit of $109 billion from 2013 through 2022, according to a Congressional Budget Office…
The Food and Drug Administration has defended itself against claims that it is a main culprit in the U.S. drug shortage dilemma.