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Compliance & Legal

By Tom Sullivan | 04:19 am | September 30, 2014
With the Office for Civil Rights gearing up to begin auditing providers, the best thing to do is to be prepared.
By Anna Gorman | 09:48 am | September 18, 2014
California's lingering backlog of Medi-Cal applications has left hundreds of thousands of people unable to access the healthcare they are entitled to receive, according to a lawsuit filed Wednesday.
By Lidia A. Rodriguez-Hupp | 11:15 am | September 02, 2014
The 340B program is critical for hospitals and other providers that serve some of our country's poorest and most vulnerable patients. When providers monitor compliance and track 340B drugs properly, the program can fulfill its intended purpose.
By Anthony Brino | 05:28 am | July 29, 2014
A Pennsylvania provider is suing a health insurance company for passing on its 2 percent reimbursement cut required by sequestration.
By Debra A. McCurdy | 11:41 am | July 25, 2014
Although a May 2014 U.S. District Court ruling vacated HRSA's 340B orphan drug regulation, the agency has issued an interpretive rule affirming its policy on the orphan drug exemption. The pharma industry is up in arms, but what does it all mean?
By Anthony Brino | 05:00 am | July 01, 2014
After more than a year of dispute over continuing a contract, insurer and new health system owner Highmark and the University of Pittsburgh Medical Center have reached a comprehensive transition agreement.
By Tammy Worth | 09:58 am | June 06, 2014
An Illinois home health case heard recently by the Supreme Court could reach far beyond that sector, dramatically changing the way labor unions operate across the country.
By Anthony Brino | 09:51 am | June 04, 2014
The American Hospital Association is asking federal Medicare leaders to stem the practice of using sample hospital audit data to extrapolate overpayments eligible for recovery. The lack of clarity regarding standards for short patient stays has clouded the issue.
By Anthony Brino | 11:32 am | May 28, 2014
A group of chiropractors went to war with the Blues and it seems they've won, successfully using a novel legal theory that now has lawyers setting their sights on other large insurers.
By Anthony Brino | 08:35 am | May 27, 2014
The federal government and a number of hospitals may want to transition to a new Medicare reimbursement model. But there are still billions of dollars in disputed fee-for-service claims waiting to be settled, sowing animosity between health systems and the feds.