The Centers for Medicare & Medicaid Services recently issued new proposed rules regarding payment and policy for skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), and Hospice providers.
The Department of Justice (DOJ) recently announced the $6 million settlement of kickback allegations against Quest Diagnostics. The original allegations were filed as a qui tam whistleblower False Claims Act (FCA) lawsuit against Berkeley HeartLab, which was acquired by Quest in 2011.
The Office of Inspector General (OIG) has issued a review of the Centers for Medicare & Medicaid Services (CMS) oversight and efforts to ensure the quality of the Inpatient Quality Reporting (IQR) data. OIG recommends that CMS use additional tools to identify anyone gaming the system.
The Centers for Medicare & Medicaid Services (CMS) introduced its Accountable Health Communities (AHC) model, an innovation to address the gap they say exists between clinical care and community services.
The U.S. Department of Justice (DOJ) has joined a whistleblower’s False Claims Act lawsuit that alleges UnitedHealthcare fraudulently overbilled the government under its Medicare Advantage (MA) health plans.
A Dallas-based anesthesiologist pled guilty to charges of conspiracy to pay healthcare bribes and kickbacks to physicians and other health professionals for referring patients to a specialty hospital that he part-owned.
The U.S. Department of Justice (DOJ) Fraud Section has updated its Evaluation of Corporate Compliance Program guidelines. While the guidelines are not specific to healthcare, they can serve as an effective standard against which compliance staff could evaluate the efficacy of current compliance programs.
The Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) will this month implement its final rule for exclusion of individuals and entities from participation in federal healthcare programs. These changes will be included under section 1128 of the Social Security Act and will broaden the power of the OIG to make such exclusions.