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National Health Spending Will Reach Nearly 20% of U.S. GDP By 2027

Health Populi

every year from 2020 to 2027, the actuaries at the Centers for Medicare and Medicaid Services forecast in their report, National Health Expenditure Projections, 2018-2927: Economic And Demographic Trends Drive Spending And Enrollment Growth , published yesterday by Health Affairs. recorded in 1990-2007. is expected to grow by 5.7%

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Federal Jury Convicts New York Doctor of Healthcare Fraud Scheme

Med-Net Compliance

A federal jury convicted a New York ENT doctor for defrauding Medicare and Medicaid by causing the submission of false and fraudulent claims for surgical procedures that were not performed. Specifically, between January 2014 and February 2018, the doctor billed Medicare and Medicaid approximately $585,000 and was paid approximately $191,000.

Fraud 59
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Seventh Circuit Clarifies “Authoritative Guidance” for the False Claims Act

Hall Render

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.” SuperValu Inc., of America v. Burr was applicable to lawsuits brought under the False Claims Act.

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SafeCo No More: The Changing Landscape of Scienter under the False Claims Act

Health Law RX

2] Companies that regularly submit claims to the federal government are familiar with the complex maze of rules and regulations that often govern them. 6] These government payor programs limit the amount pharmacies can charge for generic medications to the “usual and customary” price. [7] per 30-day supply). [9] June 1, 2023).

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Everything You Need To Know About NPI Numbers

Verisys

The Centers for Medicare & Medicaid Services (CMS) oversees the issuance and regulation of NPI numbers, ensuring providers meet accountability standards. This requirement improves the efficiency and quality of Medicare, Medicaid, and other state and federally funded healthcare programs.

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Florida Woman Lands Herself 6.5 Years in Prison, Owes $45 Million for Medicare Fraud Scheme

Pharmacy Law Blog

Supreme Court decision in her case holding that the government could not freeze untainted assets. Her case continued in 2017 following a 5-3 ruling by the Supreme Court holding that the government could not freeze assets belonging to her that were not tied to the alleged fraud scheme. To read more on the U.S. Let’s see.

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Physicians Beware! Groups Providing DME, Prosthetic Devices, and Other Medical Supplies to Their Medicare Patients Risk Violating the Strict Liability Stark Law Since the Expiration of COVID-19 Public Health Emergency

Health Law Advisor

2] Centers for Medicare & Medicaid Services, Spotlight: Physician-Owned Hospital Expansion Exception Requests – Changes Effective October 1, 2023 , available at [link] (last accessed August 2, 2023). [3] 5, 2007) (emphasis added). [5] 2, 2023). [2] 2, 2023). [4] 2, 2023). [2] 2, 2023). [4] 2, 2023). [2] 2, 2023). [4] at 51020. [6]