Compliance & Legal

Whether misdiagnosis results in patient harm, wasted resources or malpractice lawsuits, it is a major concern for hospitals.

Contractors hired by Medicare to audit the payment records of healthcare providers have a good track record spotting improper billing, the HHS Inspector General concluded in a recent report, but legitimate concerns about their efficacy exist.

During the 2009 and 2010 fiscal years, 92 percent of the $95 million Alabama received in enrollment bonuses for the Children's Health Insurance Program was "not allowable in accordance with federal requirements," according to the U.S. Department of Health and Human Services' Office of the Inspector General.

Defensive medicine has contributed to the rising cost of healthcare in the U.S. But two recent reports suggest the true scope of the problem may be somewhat exaggerated, and the solution not too complex.

Fraud in Kansas' Medicaid program increased 43 percent during the last fiscal year, reaching a state record of $33 million detected.

You could put off communicating with your healthcare payers until you submit your first ICD-10 coded claim Oct. 1, 2014. What could go wrong?

A recent Moody’s Investment Service report says that several recent developments will likely have long-term consequences for the generic drug industry.

The benefit of nonprofit hospitals to their surrounding community has increasingly been coming under scrutiny -- at least in relation to whether or not the benefit is equal to their tax-exempt status.

In today’s healthcare environment, providers must carefully balance the need to control costs against their mission to deliver the highest quality care.

Put to rest any hopes that Recovery Audit Contractors, or RACs, will be going away anytime soon.