Horizon Blue Cross Blue Shield of New Jersey has filed two lawsuits against two separate hospitals over billing practices at the facilities, according Horizon news releases.
Legal & Regulatory Issues
The Queen's Medical Center in Honolulu, Hawaii, agreed to pay $2.5 million to settle two whistle-blower lawsuits that alleged the hospital overbilled government healthcare programs for prescription medications, according to a report in the Pacific Business News.
In two letters to CMS, the American Hospital Association said it was pleased that the agency decided to rescind its final rule changing Medicaid policy for federal reimbursement of Medicaid hospital outpatient services and "applauded" CMS' proposal to delay until…
Hospitals are planning a lobbying campaign to stop Congress from adding a minimal level of charity care required for hospitals to maintain their tax-exempt status, according to a report in the New York Times.
CMS does not expect its Medicare recovery audit contractors to conduct complex reviews for medical necessity of hospital services until 2010, according to a news release from the American Hospital Association.
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President Obama's plan to reduce healthcare spending — which calls for the collaboration of doctors, insurers and healthcare facilities to develop a strategy that would slow the growth of healthcare costs — creates legal risks for the companies involved, according…
Senator John D. Rockefeller IV (D-W.Va.) introduced new legislation to Congress that would expand the role of the Medicare Payment Advisory Commission to determine and implement Medicare reimbursement policies, according to a news release from Sen. Rockefeller's office.
Three hospitals in the St. Paul, Minn.-based HealthEast Care System agreed to pay the United States $2.28 million to settle allegations that they submitted false claims to Medicare, according to a U.S. Department of Justice news release.
CMS has issued answers to four new frequently asked questions regarding Recovery Audit Contractors. They are as follows:
Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius have announced the creation of a new interagency effort, the Health Care Fraud Prevention and Enforcement Action Team, to combat Medicare fraud, according to a U.S. Department of…