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2024 Final Rule: CMS Announces More Changes to Medicare Advantage but Declines to Reform the “60 Day Rule”

Health Care Law Brief

405.986) or “reliable evidence” of fraud or “similar fault” (as defined in 42 C.F.R. MA plans will be required to have a Utilization Management Committee that conducts annual reviews of policies to ensure compliance with the foregoing. Final Rule at p. 3729(b)(1)(A) of the False Claims Act (“FCA”). See Proposed Rule at 79559.

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ChristianaCare Settlement Drives New Legal Theory in False Claims Act Litigation: Hospitals Take Note When Providing Clinical Services to Their Private Physician Groups

Healthcare Law Blog

million to resolve a lawsuit filed by the system’s former Chief Compliance Officer, Ronald Sherman. Global billing or collaborative care arrangements are not per se violations of the Anti-Kickback Statute, however, there is greater fraud and abuse risk in these types of arrangements unless there is active, ongoing monitoring for compliance.

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2018 Medicare Fee-For-Service improper payment rate is lowest since 2010

CMS.gov

2018 Medicare Fee-For-Service improper payment rate is lowest since 2010. Fraud, waste, & abuse. 2018 Medicare Fee-For-Service improper payment rate is lowest since 2010 Significant progress in saving $4.59B in estimated improper payments for the Medicare Fee-For-Service program. Jeremy.Booth@c…. Fri, 11/16/2018 - 18:46.