Legal & Regulatory Issues

Hospitals and health systems today operate in one of the most challenging environments in the history of the healthcare industry. Regulatory and reimbursement pressures continue to tax facilities, and the growth of government-sponsored healthcare programs further constrain revenues. In response,…

Catholic bishops said they would not support President Barack Obama's compromise on the mandate requiring most employers to cover contraception in their employees' health plans, according to a Wall Street Journal report.

A federal judge has approved the distribution of roughly $200 million in settlement payments from health insurer UnitedHealth Group to physicians from a 2009 class-action lawsuit stemming from low reimbursements of out-of-network services, according to an American Medical Association news…

This month, Illinois officials will begin matching addresses of Medicaid recipients against state driving records to ensure the federal funds aren't moving out of the state, according to a Chicago Tribune report.

The Office of Inspector General is encouraging physicians to scrutinize entities before they reassign their right to bill the Medicare program, since the physicians may be liable if false claims are submitted by those entities.

A Houston hospital executive has been indicted for allegedly participating in a $116 million Medicare fraud scheme, according to a Department of Justice news release.

Emergency departments at some of Utah's major hospitals might be accountable for $22 million in Medicaid funds for allegedly charging emergency rates for non-emergency care, according to a Salt Lake Tribune report.

A federal appeals court has ruled in a split decision that seniors receiving Social Security cannot opt out of Medicare, according to an Associated Press/Washington Post report.

The American Society of Anesthesiologists has joined several other organizations in urging CMS to include assessment, diagnosis, treatment and management of acute or chronic pain in the "essential health benefits" package under healthcare reform, according to an ASA release.

Fourteen hospitals have agreed to pay more than $12 million combined to settle federal allegations that they defrauded Medicare by overbilling for kyphoplasty procedures, according to a news release from the Department of Justice.