Compliance & Legal
The lawsuit was linked to past risk adjustment submissions from certain types of patient records, some dating back more than a decade.
Drug manufacturers must now enter into an agreement with HHS to take part in the price negotiation process.
LCMC investments include $220 million in clinical service lines that will transfer from Tulane Medical Center to East Jefferson General Hospital.
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.
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.