Legal & Regulatory Issues

Manuel Anthony Puig and his wife Romelia Sanchez Puig, both of Edinburg, Texas, were indicted by a federal grand jury for healthcare fraud, mail fraud and conspiracy to commit healthcare fraud, according to a news release from the U.S. Attorney's…

A new bill proposed in the Florida legislature would give the state's attorney general power to investigate private managed care companies that administer Medicaid, according to a report in the South Florida Business Journal.

The Senate has voted to pass the American Workers, State and Business Relief Act of 2010 (HR 4213), which includes language that would delay the 21 percent Medicare payment cut to physicians until Sept. 30 and would extend through Dec.…

The AHA is disputing WellPoint's assertion at a recent congressional hearing that "provider consolidation" is a key driver of higher health insurance premiums, according to a report from AHA News Now.

Wisconsin Gov. Jim Doyle has signed legislation that requires hospitals, physicians and other healthcare providers to disclose the cost of the most common procedures they perform so consumers have price-estimates before choosing a provider, according to a release by Gov.…

Abdul Naushad, MD, his wife, their six pain management clinics and their billing company have agreed to pay $820,000 to resolve civil Medicare fraud allegations, according to an announcement by the U.S. Attorney's Office for the Eastern District of Missouri.

Blue Cross Blue Shield of Michigan's subsidiary, Blue Care Networks of Michigan, abandoned its attempt to purchase Physicians Health Plan of Mid-Michigan after the Department of Justice informed the companies that it would file an antitrust lawsuit to block the…

Connecticut's Attorney General Richard Blumenthal notified Department of Health and Human Services Secretary Kathleen Sebelius of "most-favored nation" clauses included in many Anthem Blue Cross & Blue Shield contracts in his state, according to a report in the Hartford Courant.

A report from the Department of Health and Human Services Office of the Inspector General found that recovery audit contractors are not sufficiently trained to accurately report potential fraud to the Centers for Medicare and Medicaid Services.

The American Hospital Association is asking the Internal Revenue Service to improve the new hospital community benefit reporting form to better reflect not-for-profit hospitals' benefits to their communities, according to a release from the AHA.