Compliance & Legal
The exec has been charged with agreeing to suppress and eliminate competition for the services of nurses.
The settlement concludes two OCR investigations initiated from a large breach report and a media article regarding a separate security incident.
The groups warned that a misrepresentation of a practitioner's level of licensing can jeopardize patient safety.
Plaintiffs alleged that LVMC claimed and received payments that were not for "allowed medical expenses" permissible under state contracts.
Bon Secours Mercy Health asserts that Anthem's denial practices have intensified since July 2021.
The court agreed that the calculation of QPAs used in dispute arbitration disadvantages physicians in payment disputes with insurers.
<p>With the expiration of the public health emergency ending waivers and flexibilities, providers are looking for answers, says Dr. Robert Murry, chief medical officer of NextGen Healthcare.</p>
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A patient requested his medical records and did not receive them for six months - after the OCR stepped in - agency says.
The lawsuit alleges that the Medicaid redeterminations began a month before they were allowed under federal legislation.
In 2022, the AG launched an investigation into Mayo Clinic, which is ongoing.