This year is on track be a record-breaking one for government recoveries in the healthcare industry, with several cases alleging violations of the False Claims Act, Stark Law or the Anti-Kickback Statute already settling for substantial amounts.
Legal & Regulatory Issues
A group of 33 Anthem Blue Cross members have filed a lawsuit against the insurer in Los Angeles County Superior Court alleging the company misrepresented the size of its physician networks and the benefits provided under the plans it offered…
The U.S. Court of Appeals for the Seventh Circuit has ruled Rush University Medical Center in Chicago cannot bill Medicare for time spent on "pure research" unrelated to direct patient care.
New York Heart Center in Syracuse, N.Y. has agreed to pay the government $1.34 million to resolve allegations the group practice compensated physicians in a manner that violated the False Claims Act and the Stark Law, according to the Department of Justice.
Tucson, Ariz.-based Carondelet Health Network has agreed to pay the government $35 million to resolve allegations its hospitals acted in violation of the False Claims Act by submitting fraudulent claims to government-run programs for reimbursement, according to the Department of…
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CMS will withhold one-third of the records it received from pharmaceutical and medical device makers under the Physician Payments Sunshine Act due to errors identified in the records, according to a report by ProPublica.
House Republicans are questioning CMS Administrator Marilyn Tavenner's action of advising staff to delete an Oct. 5, 2013, email from her concerning how to handle telephone calls from people applying for health coverage under the Patient Protection and Affordable Care…
The Veterans Affairs Department and VA Secretary Robert McDonald have announced they are working as quickly as possible to fire employees who were responsible for the long wait times many veterans faced at VA facilities across the country, according to…
A recent study from the economic research nonprofit Mercatus Center at George Mason University challenges the economic logic behind certificates of need.
With nearly 4.5 million Medicare claims coming through the system each day, locating fraud is an endless battle for members of the Medicare Fraud Strike Force, according to the report by The Wall Street Journal.