The U.S. Department of Health and Human Services (HHS) has issued a final rule that replaces the ICD-9-CM code set with ICD-10 code sets.
Legal & Regulatory Issues
The Government Accountability Office (GAO) is urging the U.S. Food and Drug Administration (FDA) to use the most stringent pre-market review process in approving high-risk medical devices, according to a GAO report.
Shortly after settling with New York Attorney General Andrew Cuomo, the nation’s second largest health insurer, Minneapolis-based UnitedHealth Group, agreed to pay $350 million to resolve a class action lawsuit with the American Medical Association (AMA) and the Medical Society,…
Minneapolis-based UnitedHealth Group has agreed to pay $50 million to settle allegations from N.Y. Attorney General Andrew Cuomo that the health plan and its wholly owned subsidiary, Ingenix, manipulated out-of-network insurance payment rates for physician fees, according to a news…
The Centers for Medicare and Medicaid Services (CMS) has, over the last several years, grown increasingly concerned with percentagebased lease arrangements, indirect financial relationships, per click payments and “under-arrangements” transactions. It has long indicated that changes to the Federal Ethics…
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U.S. District Judge Patricia Seitz has sentenced two Miami brothers who headed a now bankrupt medical supply company to nearly nine years in prison for swindling a South Florida HCA hospital, according to a press release from the United States…
The Office of the Inspector General of the Department of Health and Human Services (OIG) issued Advisory Opinion No. 08-22 on Dec. 8, 2008. In the Advisory Opinion, the OIG analyzed a proposed arrangement under which a non-profit, tax-exempt corporation…
The American Hospital Association has sent a legislative health reform proposal to Congress recommending a number of significant changes including a renewed ban on physician self-referrals.
Seven hospitals in New York are accused of fraudulently billing Medicaid for more than $50 million, according to a report by the Associated Press.
Durable medical equipment (DME) suppliers have come under further scrutiny from CMS as the organization has announced a series of anti-fraud measures.