Legal & Regulatory Issues

Insurers should be prevented from tweaking the reported amounts they spend on medical care to comply with the new healthcare reform law, according to a letter from Sen. Jay Rockefeller (D-W.Va.) to Department of Health and Human Services' Secretary Kathleen…

While pay-for-performance programs are gaining traction, most programs have focused on primary care and not on specialists, according to a recent New England Journal of Medicine report.

A Clark County (Nev.) District Court jury order Teva Pharmaceutical Industries, which manufactures propofol injections, and Baxter Healthcare, which distributed the drug, to pay a combined $500 million in punitive damages to Henry Chanin and his wife, after Mr. Chanin…

Changes mandated by the Patient Protection and Affordable Care Act will require all Medicare fee-for-service claims to be submitted within 12 months (one calendar year) of the date of service in order to receive reimbursement, according to an MLN Matters…

Officials from Minnesota's hospital, nurse and physicians' associations are urging state lawmakers and Governor Tim Pawlenty to cover the state's low-income residents with the state-federal Medicaid plan rather than a revamped General Assistance Medical Care plan negotiated in April, according…

A recent OIG report suggests a temporary provision that allows medical equipment suppliers to list their national provider identifier instead of the ordering physician's NPI creates a potential risk for Medicare fraud, according to a report by American Medical News.

With college graduations starting, the Obama administration will ask insurers to allow young adults to say on their parents' plans until age 26 rather than wait until this standard is required on Sept. 23, according to report by ABC News.

John D. Kristofic, MD, an internal medicine physician in Pittsburgh, has been sentenced to one year in prison followed by three years of supervised release for committing healthcare fraud, according to a news release by Acting United States Attorney for…

Arizona has become the 19th state to reject a federal invitation to set up a high-risk pool to cover patients with pre-existing medical conditions under health reform, according to a report by the Arizona Republic.

Senator Patrick Leahy (D-Vt.) filed an amendment to the pending Wall Street reform legislation to repeal the health insurance industry's exemption from federal antitrust laws, after previously failing to get such a measure included into the healthcare reform law passed…