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Compliance & Legal

By Jeff Lagasse | 04:02 pm | September 30, 2024
To date, New York has refunded approximately $10 million to the federal government and recovered roughly $19 million in unallowable payments.
By Jeff Lagasse | 04:45 pm | September 26, 2024
GAO identified systemic issues that impair Medicaid's ability to root out fraudulent activities and offered recommendations.
By Susan Morse | 04:51 pm | September 25, 2024
Medicare claims for catheters have increased, and CMS found a rise in billings by a small group of durable medical equipment supply companies.
By Jeff Lagasse | 03:10 pm | September 23, 2024
Particle Health claims Epic is intentionally stifling its ability to send and receive health information.
By Susan Morse | 10:47 am | September 23, 2024
Caremark, Express Scripts, Optum and their GPOs created a rebate system that boosted PBM profits, FTC alleges.
By Jeff Lagasse | 10:04 am | September 20, 2024
Payments to insurance agents incentivize them to base referrals on financial considerations, DOJ says.
By Susan Morse | 05:19 pm | September 19, 2024
Fifteen patients at Steward hospitals have died due to a lack of medical equipment or staffing shortages, says Chairman Bernie Sanders.
By Jeff Lagasse | 11:47 am | September 19, 2024
Confusion around CMS' final rules has been a challenge, yet the industry continues to advance seamless data exchange.
By Susan Morse | 11:11 am | September 19, 2024
The drug company faces civil monetary penalties and the termination of its Pharmaceutical Pricing Agreement.
By Jeff Lagasse | 03:02 pm | September 18, 2024
Express Scripts is demanding the FTC retract its report, claiming it's filled with "false and misleading claims."