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Compliance & Legal

By Beth Jones Sanborn | 04:11 pm | February 15, 2018
In early December, Triple-S Advantage discovered that notices sent in November to providers involved in the treatment the insurer's members were mailed to the wrong address.
By Susan Morse | 03:57 pm | February 15, 2018
Piedmont Hospital has brought a lawsuit saying the insurer has breached their contract in not paying for some MRI and CT scans.
By Susan Morse | 12:37 pm | February 14, 2018
A deposition reveals former medical director never looked at patient medical records, but Aetna says correct guidelines were followed.
By Beth Jones Sanborn | 02:00 pm | February 08, 2018
The payer and the claims administrator hired to execute a mailing are accusing each other of negligence and failing to protect members' private health information.
By Beth Jones Sanborn | 11:48 am | February 06, 2018
Molina also said that a contracting consultant for the department had "financial ties" to a company affiliated with the winning bidder.
By Jessica Davis | 12:06 pm | February 02, 2018
The first enforcement settlement of the year follows an OCR investigation of Fresenius Medical Care North America that began in 2013 after a string of breaches in its clinics across the U.S. the prior year.
By Susan Morse | 04:13 pm | January 31, 2018
The U.S. Court of Appeals on Tuesday accepted a request by the American Hospital Association and five other healthcare groups for an expedited brief schedule.
By Jeff Lagasse | 11:30 am | January 31, 2018
Brenda Fitzgerald bought stock in Japan Tobacco in August 2017, one month into her tenure as the agency's director.
By Susan Morse | 10:22 am | January 25, 2018
Seeking class action status, the suit claims CMS Administrator Seema Verma, acting HHS Secretary Eric Hargan and others bypassed legislative processes.
By Beth Jones Sanborn | 01:47 pm | January 22, 2018
A whistleblower lawsuit was originally filed by a former Scripps employee about unsupervised physical therapy services.