Legal & Regulatory Issues

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.

Most practices are frustrated with reporting requirements for Medicare's Physician Quality Reporting Initiative and unhappy with its guidances to improve outcomes, according to a release by the Medical Group Management Association.

A federal appeals court has stopped the State of California from cutting Medi-Cal payments to physicians and hospitals by 5 percent, according to a report by the San Francisco Chronicle.

Virginia lawmakers are expected this week to pass legislation that would prohibit health insurance mandates and would make clear that no individual can be required to obtain coverage, according to a report by the Boston Globe.