The Centers for Medicare & Medicaid Services has proposed a rule that would allow the agency to collect baseline data on probable fraud payments in the home health industry and launch a preauthorization pilot project in five states.
The Centers for Medicare & Medicaid Services has finalized rules that specify when the 60-day clock begins ticking for providers to return overpayments, and shaves four years off of the overpayment lookback period, according to FierceHealthFinance.
Nearly three years after the New Mexico Human Services Department cut off Medicaid funding to 15 behavioral health providers, Attorney General Hector Balderas has cleared 10 companies of criminal fraud allegations, his office announced Monday.
Legislators are asking industry stakeholders for input regarding potential changes to. Stark law in light of the ongoing transition towards value-based payments, according to a report by Bloomberg BNA.
More than a dozen organizations submitted amicus briefs to the Supreme Court last week, imploring the court to overturn a False Claims Act decision that relies on a broach interpretation of "implied certification," according to case updates on SCOTUSblog.
A prominent physician and former CEO of an Oregon health system says he was fired by the governing board last year for suggesting the provider self-report $10 million in improper Medicare claims, according to The Oregonian,
Health payers are intensifying investigations into addiction treatment services with more comprehensive records requests, according to one healthcare attorney.
Last year was a terrible, horrible, no good, very bad year for PharMerica Corp., the second largest pharmacy operator in the country that ended up spending $43.25 million to resolve multiple False Claims Act allegations from the federal government. In the span of 12 months, the company negotiated multi-million dollar settlements and entered into another corporate integrity agreement for accepting kickbacks and illegally dispensing drugs.
A psychiatrist indicted for illegally selling prescriptions for nearly 10,900 pain pills has a history of illegal prescribing practices and Medicare fraud dating back 30 years, according to lohud.com.
With fewer False Claims Act recoveries, some might say 2015 was a down year for federal fraud enforcement. But attorneys across the country say federal policy changes and FCA trends will keep fraud concerns high on the government's radar in the coming year.