Compliance & Legal
Jorge Juvier, 58, of Queens, New York, a former owner and operator of multiple HIV/AIDS clinics in New York City, was sentenced Tuesday to a little more than five years in prison and ordered to pay more than $12 million in restitution for his role in a scheme to bilk Medicare out of more than $12 million through the use of fraudulent HIV/AIDS clinics, the U.S. Attorney's office announced.
At the request of the Orlando Health CEO David Strong, the White House has waived HIPAA privacy regulations so that families can get information on the victims of the nation's deadliest shooting Sunday at the Pulse night club.
Despite interventions by Medicare officials, the number of appeals from health care providers and patients challenging denied claims continues to spiral, increasing the backlog of cases and delaying many decisions well beyond the timeframes set by law, according to a government study released Thursday.
The Carolinas Healthcare system on Thursday was slapped with an antitrust suit by the state of North Carolina alleging that the system's Charlotte-Mecklenburg Hospital Authority used its large size to exert market power in dealing with commercial health insurers and to negotiate higher reimbursement rates for treating insured patients.
The Department of Veterans Affairs publicly announced on Wednesday that is formally removed three senior officials from the Phoenix VA Health Care System in the continuing wait-time scandal.
Three additional defendants, including the son of a southern California hospital owner, have pleaded guilty in an elaborate healthcare fraud scheme that authorities say spawned tens of millions of dollars in illegal kickbacks for patient referrals, and nearly $600 million in fraudulent bills for spinal surgeries performed at Pacific Hospital in Long Beach, the Justice Department announced.
California insurance officials are looking into whether Health Net Inc. has improperly withheld payments to addiction treatment centers for months while the company investigates concerns about fraudulent claims.
The merger, and another mega-merger proposal between Anthem and Cigna for $54 billion, is going through the federal regulatory process and approval in certain states.
Blue Cross Blue Shield of North Carolina is seeking $130 million from the government for payments owed for 2014, the insurer said.
Dr. Elizabeth Nabel, president of Boston's Brigham and Women's Hospital, has come under scrutiny in reports that she was part of the National Football League's attempt to influence funding decisions at the National Institutes of Health.