Healthcare Law Today

JANUARY 2, 2023

” The currently proposed provision has similar effect to the language CMS proposed in 2012 and, after consideration of comments, ultimately rejected in the 2014 Final Rule (Medicare Advantage and Part D) and 2016 Final Rule (Medicare Part A and Part B). The FCA is a fraud statute, requiring intent. 3729(b)(1)(A).

Overpayments 52

Overpayments Overpayment ACA Medicare 52

Health Populi

APRIL 24, 2018

” The brief answer is that the country experienced a huge fraud incident discovered in 2017 , involving 18 networks of corruption leading to at least 42 criminal cases. The resulting monetary loss was calculated to be at least $160 mm of fraud in 2017 alone. But you may be asking, “What happened in Colombia?”

Health Insurance 74

Health Insurance Fraud Hospitals Nurses 74

Health Populi

OCTOBER 8, 2019

The study reviewed reports and articles published between January 1, 2012 and May 15, 2019, dressing the topic of waste across six domains previously identified by the Institute of Medicine: Failure of care delivery, with waste ranging between $102 bn and $166 bn. Failure of care coordination, with a waste-range of $27 bn – $78 bn.

Prescription Drug Pricing 108

Prescription Drug Pricing Medicare Medicare ACA 108