Kaiser Health News

JANUARY 19, 2022

” The changes are part of a 400-page proposed rule governing the federal health insurance marketplace and a few states that use the federal platform for their own exchanges. The new broker provision aims to deter fraudulent sign-ups by clarifying that applicants must attest that the income projections listed are correct.

ACA 72

ACA Health Insurance Licensing Governance 72

Verisys

JANUARY 18, 2022

A healthcare facility’s accountability and overall reputation are dependent upon rigorous credentialing processes compliant with governing regulatory bodies, such as the National Committee for Quality Assurance. Verisys’ owned and maintained Fraud Abuse Control Information System (FACIS) is a provider data supersource.

Licensing 52

Licensing Medicaid Medicaid Governance 52

Hall Render

APRIL 6, 2022

Turning to the present case, in Safeway , the relator alleged that the defendant engaged in the submission of false claims to the government when it “reported its ‘retail’ price for certain drugs as its ‘usual and customary’ price.” This footnote originated as a footnote in a memorandum issued by CMS in October of 2006. Practical Takeaways.

Medicare 72

Medicare Medicare Medicaid Medicaid 72

Health Law RX

JULY 18, 2023

The CMP Final Rule also addresses enforcement and CMPs for fraud, false claims, or similar conduct in HHS grants, contracts, and other agreements, which are not addressed in this article. As context, between 2015 and 2022, the DOJ reported FCA settlements with health IT vendors in an amount exceeding $500 million.

Fraud 52

Fraud Compliance Medicaid Medicaid 52

Hall Render

DECEMBER 22, 2023

fraud scheme UConn Health is in financial trouble. health care spending hits $4.5 approval for obstetrics services in Prince George’s County Maryland health system gets state OK for $300M labor, delivery unit Maryland hospitals must pay back millions to poor patients.

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

APRIL 21, 2023

health-tech startup MemoryWell pivots, eyes new funding to roll out software for insurers Department of Veterans Affairs health system kicks off multiyear Greater Washington expansion Georgetown to open Southeast D.C.

US Department of Health and Human Services 40

US Department of Health and Human Services COVID-19 Nurses Nursing Homes 40

Drug & Device Law

DECEMBER 29, 2023

2023) (federal government may unilaterally obtain dismissal of FCA claims, and calling the constitutionality of the FCA’s private enforcement mechanism into question) ( here ); Quishenberry v. 2023) (rejecting any express anti-preemption presumption in Medicare case) ( here ); Baker v. Executive Health Resources, Inc. , 3d 239 (Cal.

FDA 105

FDA US Department of Health and Human Services COVID-19 Informed Consent 105

Drug & Device Law

JANUARY 30, 2023

470 (1996), was decided – removing express preemption as a defense for manufacturers of §510(k) products So defendants moved on fraud on the FDA under an implied preemption theory and won. Mensing , 564 U.S. Mensing , 564 U.S. Lohr , 518 U.S. Davidowitz , 312 U.S. Davidowitz , 312 U.S.

FDA 72

FDA Fraud Governance Medicare 72