Compliance & Legal
Saint Michael's Medical Center in Newark, New Jersey will pay almost half a million dollars to resolve allegations they falsely billed Medicare and Medicaid for medically unnecessary cardiac procedures over the course of six years, the U.S. Attorney's office announced.
In Ohio, Coordinated Health Mutual is in receivership due to its extensive financial losses in the exchange market under its InHealth Mutual brand, according to Lt. Gov. Mary Taylor, who is also Ohio Director of Insurance.
Theranos, which has come under fire in recent months for allegations that its proprietary finger-prick blood testing technology is subpar, is now the focus of a class action lawsuit accusing the company of consumer fraud.
The U.S. Department of Justice on Monday filed a notice to join a whistleblower lawsuit against for-profit provider Prime Healthcare alleging it routinely submitted inpatient claims for patients who should have been treated as outpatients.
A federal jury has convicted two California doctors of multiple counts of healthcare fraud after participating in a hospice care scheme that robbed Medicare and Medi-Cal of almost $7.5 million dollars, the Department of Justice announced earlier this month.
Payers have until June 6 to submit documents for Medicare's Annual Election Period materials including the Annual Notification of Change, Evidence of Coverage and Summary of Benefits documents.
The Centers for Medicare and Medicaid Services has paid $27.3 million out of the $223 million Highmark is owed for 2014 under the ACA's risk corridor program, the company said.
Employer wellness programs can gather medical information from employees and spouses -- so long as financial incentives or penalties don't exceed 30 percent of the annual cost for an individual in the company's group health plan, according to final rules issued by the Equal Employment Opportunity Commission Monday.
A federal judge has ruled that part of the Affordable Care Act is unconstitutional because it appropriates funds not approved by Congress.
The Federal Trade Commission is appealing a Pennsylvania judge's decision allowing the merger between PinnacleHealth and Penn State Hershey Medical Center to go forward, according to court documents.