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Compliance & Legal

By Susan Morse | 12:24 pm | March 08, 2016
The Centers for Medicare and Medicaid Services has levied a $3.1 million penalty against Humana, the single largest imposed against 129 organizations found in violation of Medicare Advantage and prescription drug plans in a 2015 audit.
By Susan Morse | 09:58 am | March 08, 2016
The U.S. Department of Justice is investigating Universal Health Systems of Pennsylvania and certain affiliated behavioral health centers for alleged billing fraud, Universal reported in a Feb. 25 filing with the Securities and Exchange Commission.
By Beth Jones Sanborn | 10:04 am | March 07, 2016
Olympus Corp. of America, the largest distributor of endoscopes and related equipment has agreed to pay $623.2 million to resolve criminal charges and civil claims stemming from a kickback scheme involving doctors and hospitals. Their Latin America subsidiary, Olympus Latin America, will pay $22.8 million to settle related charges, the U.S. Attorney's Office announced earlier this month.
By Beth Jones Sanborn | 07:15 pm | February 29, 2016
Two Dallas-area doctors have been charged, according to a superseding indictment that was unsealed Friday, for their alleged participation in a $13.4 million health care fraud scheme that bilked Medicare for millions.
By Jeff Lagasse | 10:50 am | February 23, 2016
Tenet Healthcare Corporation has offered to pay $238 million to resolve a False Claims Act lawsuit alleging that it received kickbacks for maternity referrals by four of its Georgia hospitals, the company revealed Monday in its fourth-quarter and full-year financial results reported to the Securities and Exchange Commission.
By Susan Morse | 02:36 pm | February 22, 2016
The owner of Alpha Diagnostics in Maryland has been convicted of bilking Medicare and Medicaid of more than $7.5 million in a fraud case authorities say resulted in the death of two patients because their radiology tests were not interpreted by a qualified radiologist.
By Jeff Lagasse | 03:05 pm | February 18, 2016
The United States Department of Justice has reached settlements with 51 hospitals in 15 states for more than $23 million related to cardiac devices that were implanted in Medicare patients in violation of Medicare coverage requirements, the agency announced Wednesday.
By Kaiser Health News | 02:17 pm | February 16, 2016
As the 2015 tax filing season gets underway, tax preparers said a delay in new health law tax forms is causing confusion for some consumers, while others want details about exemptions from increasingly stiff penalties for not having insurance.
By Beth Jones Sanborn | 09:48 am | February 15, 2016
Labib E. Riachi, MD, of Westfield, New Jersey, along with two companies that he owns and operates, has agreed to pay $5.25 million to resolve allegations that they submitted fraudulent claims to Medicare and Medicaid for diagnostic tests that were never performed, the U.S. Attorney's Office announced Friday.
By Jeff Lagasse | 03:14 pm | February 11, 2016
The U.S. Department of Justice is investigating potential fraudulent claims and billing linked to specialty creams, including one marketed by former Green Bay Packers quarterback Brett Favre, that claimed to treat pain symptoms.