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Compliance & Legal

By Richard Pizzi | 06:15 pm | August 07, 2014
Just in case you didn't get the memo earlier this week, hospitals should take note that the Centers for Medicare & Medicaid Services will soon allow Recovery Auditors to restart some reviews.
By Bobbi Brown | 11:38 am | July 30, 2014
If hospitals want to survive the new healthcare environment, they can't simply brace themselves for the Centers for Medicare & Medicaid Services' new reporting measures -- they must proactively improve their quality scores.
By Anthony Brino | 06:28 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 | 12:41 pm | 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 | 06:00 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 William McElmurry | 12:11 pm | June 09, 2014
With Congress delaying the date for ICD-10 compliance to Oct. 1, 2015, you have a great opportunity to re-assess your organization's implementation progress. Make sure these six crucial tasks are on your ICD-10 punch list.
By Tammy Worth | 10:58 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 | 10:51 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 Keith Borglum | 11:51 am | June 02, 2014
If you are considering buying a minority interest in a medical practice or other healthcare business, review the seller's appraisal carefully to make sure it is of the appropriate, specified equity interest. Are you really getting a "discount" when it comes with little to no control?
By Anthony Brino | 12:32 pm | 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.