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Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

In one incident, a New Jersey pharmacy admitted to conspiracies to defraud benefits providers, including Medicare and Medicaid, of $65 million for medications never provided to patients. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received.

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Fifth Circuit Upholds ACA Risk Adjustment Program

Healthcare Law Blog

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger insurers. See Vista Health Plan, Inc. United States Dep’t of Health & Hum. at 15,432 ); and.

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Importance of Regulatory Compliance in Healthcare

Compliancy Group

Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. It also reduces waste, fraud, and abuse that threaten the efficiency of healthcare delivery and services. name, phone number).

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Health Provider News

Hall Render

NATIONAL AHA, FAH request CMS to extend comment period for TEAM proposed rule CMS launches new option to file EMTALA complaints Cybersecurity execs share healthcare’s biggest vulnerabilities Here’s how much hospital prices are rising – and why Hospital groups seek more time to comment on proposed payment model How noncompete ban could shake (..)

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Texas OIG Inspectors Discover Errors in Reported Nursing Home Staff Hours

Med-Net Compliance

On November 3, 2022, the OIG released the results of a recent inspection of a nursing home by the Texas Health and Human Services (HHS) Office of Inspector General Audit and Inspections Division (OIG Inspections).

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Health Provider News

Hall Render

Vincent and Morehouse School of Medicine of Atlanta to launch partnership Fayetteville nonprofit to offer state’s first-ever medical respite program for the unhoused Mercy Arkansas Hospitals receive designation Sage Health to Open Third Central Arkansas Location UAMS snags $11.5M after cyberattack CHI St. after cyberattack CHI St.

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A Health-Heavy State of the Union

Kaiser Health News

Julie Rovner is chief Washington correspondent and host of KHN’s weekly health policy news podcast, “What the Health?” ” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.