Legal & Regulatory Issues

The University of Medicine and Dentistry of New Jersey has agreed to pay $2 million to settle federal civil fraud allegations that its hospital defrauded Medicaid, according to a news release from the U.S. Department of Justice.

It's Monday morning and your week appears to be off to a very bad start. You just received a call from a law enforcement officer. A patient's identity has been stolen, and the information breach was traced to his dealings…

The following common red flags apply to many healthcare entities. Please note that this is not an all-inclusive list and that not all of these flags will apply to all healthcare organizations.

In a letter to Sen. Edward Kennedy (D-Mass.) and Sen. Max Baucus (D-Mont.), President Obama said he was open to giving special considerations to Medicare Payment Advisory Commission recommendations, according to a report in the Wall Street Journal.

The key issue in the emerging national health care debate is the role of the federal government. While some Members of Congress favor a "single-payer" national health insurance system—"Medicare for all"—others, including President Obama, propose a new public plan, modeled…

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.

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.