Legal & Regulatory Issues

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…

Deborah Heart & Lung Center in Brown Mills, N.J., is suing Virtua Health, accusing Virtua Memorial Hospital in Mt. Holly, N.J., and four cardiologists from The Cardiology Group of slander and unfair competition, according to a report by the Philadelphia…

CMS, in the FY 2008 and FY 2009 IPPS regulations, finalized changes relating to hospitals serving Medicare/Medicaid beneficiaries that require such hospitals and their physician owners to disclose physician ownership information to patients. The disclosure requirements become effective June 8,…

A study has found that the total cost of medical practice interaction with insurers is $21-$31 billion a year, or more than $68,000 per physician on average, according to an MGMA news release.

This is a short summary of 15 anti-kickback and fraud cases and investigations that have made headlines in 2009. The situations involve a range of participants including hospitals, device companies, physicians, payors and other suppliers.  

Officials from the Obama administration announced that due to the recession, the Medicare fund is expected to run out of money by 2017, two years earlier than had been previously predicted, according to a report in The New York Times.…

The U.S. Food and Drug Administration will review its decision to approve the Menaflex knee-surgery device after several scientists and FDA managers raised objections over the approval process, according to an article in The Wall Street Journal.  

In a letter to Assistant Attorney General for Antitrust Christine Varney, the American Hospital Association executive vice president Rick Pollack encouraged the Antitrust Division of the U.S. Department of Justice to take a closer look at health insurance plan consolidation,…

A recent report from the Institute of Medicine recommends several actions to improve disclosure of financial ties between the medical community and industry, limit company payments and gifts and remove industry influence from medical education and the development of practice…

Daniel Levinson, inspector general for the U.S. Department of Health & Human Services, testified before the Senate Special Committee on Aging about fraud, error, waste and abuse in state and federal health programs.