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Compliance & Legal

By Beth Jones Sanborn | 10:16 am | February 11, 2016
The U.S. Attorney's office has filed a civil suit against a prominent New Jersey doctor for allegedly causing the submission of millions of dollars in fraudulent claims to Medicare and Medicaid, among other illegal conduct, in violation of the False Claims Act.
By Henry Powderly | 09:56 am | February 11, 2016
The Centers for Medicare and Medicaid Services on Thursday published a final rule that requires healthcare providers to repay overpayments discovered within six years of the initial Medicare reimbursement, a significantly shorter lookback period than first proposed.
By Jessica Davis | 11:25 am | February 09, 2016
The Department of Health and Human Services has proposed new rules on patient record disclosures to ensure substance use disorder patients can participate in new integrated healthcare models without risk of having their records shared inappropriately.
By Susan Morse | 11:04 am | February 04, 2016
Former Turing CEO Martin Shkreli on Thursday invoked his Fifth Amendment rights while members of a Congressional committee grilled pharmaceutical executives about the high price of prescription drugs.
By Beth Jones Sanborn | 04:44 pm | February 01, 2016
Ten people have been charged in a tangled Medicare fraud scheme involving several Los Angeles area rehab and physical therapy facilities that together fraudulently billed Medicare for roughly $15 million, the U.S. Attorney's Office announced on Friday.
By Jeff Lagasse | 09:11 am | January 28, 2016
The Jackson Health System's efforts to build a 100-bed hospital in Doral, Florida are being met with resistance by five hospitals in the state, which are challenging state regulators' approval of the facility.
By Jessica Davis | 08:50 am | January 27, 2016
Intermountain Healthcare is rolling out mobile, cloud-based rounding and audit compliance tools powered by Nashville-based ReadyPoint.
By Beth Jones Sanborn | 09:33 am | January 26, 2016
The owner and manager of three home healthcare agencies, all located in the Miami area, has been convicted in a scheme that defrauded Medicare for $40 million, the U.S. Department of Justice announced Friday.
By Jeff Lagasse | 03:13 pm | January 25, 2016
The United States Department of Justice has given its blessing to a district court in New York to allow ex-pharmaceutical CEO Martin Shkreli to travel to Washington, D.C. to testify at a hearing on drug pricing on February 4.
By Susan Morse | 02:48 pm | January 25, 2016
Deficiencies found in an audit of Cigna-HealthSpring operations has prompted the Centers for Medicare and Medicaid Services to temporarily bar Cigna from enrolling new customers to its Medicare Advantage and stand-alone prescription drug plans, and from marketing efforts, according to CMS.