Hamot Hospital, a University of Pittsburgh Medical Center affiliate, and Medicor Associates Inc., a regional physician cardiology group practice, will pay the U.S. government $20.75 million to settle claims that they violated the Stark Law on physician self-referrals and the Anti-Kickback Statute.
The U.S. District Court for the District of Columbia recently vacated a Centers for Medicare and Medicaid Services (CMS) final rule. That rule would have limited hospitals’ Medicaid disproportionate share hospital payments based on Medicare or private insurer payments they received. This decision follows a Missouri court that likewise found CMS exceeded its Medicaid Act authority.
On February 2, the Department of Health and Human Services announced that it approved a waiver request by the state of Indiana to include work requirements in its Healthy Indiana Plan. This comes on the heels of approved changes to Kentucky’s Medicaid program, which also instituted work requirements.
Fresenius Medical Care North America (FMCNA) will pay $3.5 million to the U.S. Department of Health and Human Services (HHS) Office for Civil Rights to settle Health Insurance Portability and Accountability Act violations. FMCNA also will adopt a “comprehensive corrective action plan,” according to an HHS press statement.
The U.S. Department of Justice has circulated an internal memo signaling that it may intervene—by seeking dismissal—in more lawsuits brought under the federal False Claims Act's qui tamprovisions. Those provisions allow “whistleblowers” to file suit on the government’s behalf and receive a portion of damages. They are aimed at reining in fraud involving government programs such as Medicaid.
Failing to protect the health information of millions of patients in violation of HIPAA has led to 21st Century Oncology Inc. settling with the Office of Civil Rights division of the Department of Health and Human Services to pay civil monetary penalties.
Pharmaceutical company United Therapeutics (UT) has agreed to pay $210 million for False Claims Act and Anti-Kickback Statute claims against them. The government alleged that UT used a foundation as a conduit to pay the copays of Medicare patients taking UT drugs.
The Centers for Medicare & Medicaid Services recently announced its updated Hospital Compare star rating system. The agency had postponed the release of the ratings for more than five months to address the concerns of some stakeholder hospitals that the previous star formulas were flawed.
A federal district court judge denied a preliminary injunction against cuts to the Medicare 340B rule that was finalized in November. Judge Rudolph Contreras of the Federal District Court for the District of Columbia ruled on Dec. 29, 2017, denying the motion filed by the American Hospital Association (AHA) and other stakeholders.