Legal & Regulatory Issues

In a lawsuit against Memorial Hermann Healthcare System in Houston, six physician-investors in a failed hospital assert that Hermann drove it out of business by threatening to change reimbursement rates with private payors that contracted with the new hospital, according…

The Centers for Medicare and Medicaid Services have issued corrections to its list of 2010 HCPCS codes, including new approved procedures for ASCs, description changes and coverage changes, which went into effect Jan. 1, 2010.

A three-judge panel from the 11th U.S. Circuit Court of Appeals has ruled that the U.S. Department of Health and Human Services is not required under the Freedom of Information Act to provide Medicare claims data to a private company,…

South Carolina regulators will reconsider three certificate-of-need proposals for hospitals in Fort Mill, S.C., as ordered to do so by an administrative law judge, according to a report by the Charlotte Business Journal.

Pennsylvania's two Democratic Senators said the Senate health reform bill would extend for one year a temporary fix of the low Medicare wage index for Pennsylvania hospitals, according to a report by the Scranton (Pa.) Times-Tribune.

The American Society of Anesthesiologists and 74 other provider and beneficiary groups have written a letter to Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi opposing the inclusion of a Medicare Independent Payment Advisory Board in the final…

South St. Louis (Mo.) Orthopedic Group has agreed to pay $200,000 to settle Medicaid and Medicare fraud charges related to services provided by a podiatrist at the clinic, according to a report in the St. Louis Business Journal.

Geffrey Alan Yielding of Jacksonville, Ark., was sentenced to 78 months imprisonment for his role in a healthcare fraud scheme, which in he was convicted of violating the healthcare anti-kickback statute and for falsifying document to conceal the fraud, according…

Colorado Springs, Colo.-based Spectranetics Corp., a medical device manufacturer, has agreed to pay the United States $4.9 million in civil damages plus a $100,000 forfeiture to resolve claims that the company illegally imported unapproved medical devices and provided them to…

Arlington (Texas) Memorial Hospital will pay $990,500 to settle a lawsuit alleging that it violated the False Claims Act by improperly billing Medicare for pulmonary-related items, according to the Dallas Business Journal.