A new report from the Government Accountability Office found tens of thousands of Medicaid beneficiaries and providers involved in potential fraudulent purchases of controlled substances, abusive purchases of controlled substances or both in five states — California, Illinois, New York,…
Legal & Regulatory Issues
Over the last few years, there have been three interesting antitrust cases involving physician-owned hospitals. From a physician-owned hospital perspective, the outcome of the cases were an outright win, a settlement and a loss. A brief discussion of each is…
A proposal for an association of doctors to set up a network to advertise services and provide referrals would not incur prosecution under the Medicare anti-kickback statute, according to an advisory opinion of the Office of the Inspector General of…
Sixty Massachusetts physicians received more than $500,000 combined in speaker's fees from Eli Lilly & Co., and as a result, Boston Medical Center is reviewing the participation of two of its physicians as possible violations of hospital policy, according to…
A new study from the RAND Corp. outlines methods that could be used to test a payment system in which physicians, hospitals and healthcare providers would be paid a set fee for treating an "episode of care," a single ailment…
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Six hospitals in Indiana and Alabama have agreed to pay the United States approximately $8.3 million to settle allegations that the healthcare facilities submitted false claims to Medicare, according to a Department of Justice news release.
The United States Department of Justice has brought civil cases against 11 cardiologists employed by the University of Medicine and Dentistry of New Jersey for allegedly receiving kickbacks to refer cardiology patients to UMDNJ's University Hospital, which caused the submission…
In a 15-8 vote, the Senate Finance Committee rejected an amendment sponsored by Sen. Jay Rockefeller (D-W.Va.) that would create a public healthcare insurance plan, according to a report in the Wall Street Journal.
The National Association of Insurance Commissioners said insurance companies are alarming Medicare beneficiaries about proposed federal health reform legislation, according to a release from the NAIC.
Although the Texas Medical Association opposes some proposed health reforms, such as a public insurance option, TMA wants reform legislation that cracks down on several insurance practices that reduce coverage, according to a TMA release.