CMS has published online most of the edits utilized in its Medically Unlikely Edit (MUE) program to improve the accuracy of claims payments for Medicare Part B services.
Legal & Regulatory Issues
The new rule requiring disclosure of physician-ownership in hospitals becomes effective Oct. 1.
CMS has issued a notice in the Federal Register approving Det Norske Veritas (DNV) Healthcare as a national accrediting program for hospitals seeking to participate in Medicare and Medicaid, according to Dan Soldato of McGuireWoods.
A class-action lawsuit against United Healthcare(UHC) has been denied its request for an injunction that would have stopped UHC's using certain practices to determine payment for out-of-network services. The suit, led by the American Medical Association and representing numerous employee…
Staten Island University Hospital (SIUH) has agreed to pay the federal government $74 million to settle claims that the hospital defrauded Medicare, Medicaid and the military's health insurance program, TRICARE, the U.S. Justice Department and the Eastern District of New…
Advertisement
From a regulatory and legal perspective, 2008 has been a year marked by increased scrutiny of physician ownership relationships in the healthcare area. In the surgery center area, the closest impacts in the regulatory and legislative area related to physician…
Provena Covenant Medical Center, a Catholic hospital in Urbana, Ill., has announced that it will seek the Illinois Supreme Court’s review of a ruling by the Illinois 4th District Appellate Court, which stripped the organization of its property-tax exemption when…
Provena Covenant Medical Center, a Catholic hospital in Urbana, Ill., has lost its property tax exemption after the Illinois 4th District Appellate Court agreed with the state Department of Revenue that Covenant's commitment to charitable care was insufficient. More worryingly,…
The Centers for Medicare and Medicaid Services (CMS) has, over the last several years, grown increasingly concerned with percentage-based lease arrangements, indirect financial relationships, per click payments and “under-arrangements” transactions. It has long indicated that changes to the Federal Ethics…
Stryker has filed a lawsuit against the U.S. Department of Justice, accusing the federal government of using subpoena requests in the ongoing probe of allegations concerning false claims submitted for Medicare and Medicaid reimbursement, according to published reports.