Compliance & Legal
A federal appeals court rejected the group’s latest attempt to get higher reimbursements for the outlier payments they received from 2008 to 2011.
The Delta variant has driven a rise in cases among nursing home residents from a low of 319 cases on June 27, to 2,696 cases on August 8.
CMS paid an estimated $16.2 billion for unsupported diagnoses in 2016, audits of Medicare Advantage plan data show.
United allegedly reduced reimbursement rates for out-of-network mental health services, thereby overcharging participants.
CMS is getting rid of the requirement made under the Trump administration because it could impose an unnecessary burden on hospitals.
Merck reaped billions while Kaiser and its members paid higher prices for two popular drugs to lower cholesterol, the lawsuit says.
Only 16 drugs approved through the pathway have ever been withdrawn, and in some cases the confirmatory trials were never done.
The suit alleged that Mednax racked up more than $50 million in improper payments as a result of unnecessary neonatal testing.
Investigations related to this type of conduct will likely increase under the Biden Administration, says antitrust expert.
Cotiviti's Nicole Neumarker asks, Without transparency, how can patients opt in as to how their information is being used?