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DOJ announces 78 people charged over $2.5 billion in false health …

(5 days ago) WEBDOJ announces 78 people charged over $2.5 billion in false health care billings. The operations resulted in seizures of more than $10.3 million in assets. The …

https://abcnews.go.com/Politics/doj-announces-78-people-charged-nationwide-health-care/story?id=100447219

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The Supreme Court’s Rulings on COVID-19 Vaccine - Bill of Health

(Just Now) WEBThe Supreme Court’s decision puts those injunctions on hold, allowing CMS’s vaccination requirements for health care workers to take effect while the cases …

https://blog.petrieflom.law.harvard.edu/2022/01/18/supreme-court-vaccine-mandate-osha-cms/

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Twenty-Three Individuals Charged in $61.5 Million Medicare Fraud …

(8 days ago) WEBMary Smelter-Bolton, 69, of Oakland County, and Cass Hawkins, 52, of Wayne County, were allegedly recruiters paid by various Jamil home health agencies to …

https://www.justice.gov/opa/pr/twenty-three-individuals-charged-615-million-medicare-fraud-schemes

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Criminal Division Case Summaries - United States Department of …

(3 days ago) WEBJune 28, 2023. Summary of Criminal Charges. Central District of California. Neda Mehrabani, 47, of Tarzana, California, was charged by information with health …

https://www.justice.gov/criminal/criminal-fraud/health-care-fraud-unit/2023-national-hcf-case-summaries

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The nightmarish Supreme Court case that could gut …

(6 days ago) WEBThe nightmarish Supreme Court case that could gut Medicaid, explained Health and Hospital Corporation v. Talevski is the single greatest threat to America’s social safety net since Paul Ryan.

https://www.vox.com/policy-and-politics/2022/11/3/23435346/supreme-court-medicaid-health-hospital-corporation-indiana-talevski

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Supreme Court's False Claims case alleges overbilling of Medicare …

(2 days ago) WEBThe Supreme Court on Tuesday hears a case that considers whether pharmacies knowingly overcharged Medicare and Medicaid under the False Claims …

https://www.npr.org/2023/04/17/1169367263/supreme-court-looks-at-whether-medicare-and-medicaid-were-overbilled-under-fraud

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US announces charges in $2.5 billion healthcare fraud takedown

(9 days ago) WEBThe cases range from allegations of falsely billing the federal Medicare insurance program for elderly and disabled Americans and paying illegal kickbacks, to …

https://www.reuters.com/legal/us-announces-charges-25-billion-healthcare-fraud-takedown-2023-06-28/

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Health-Related Litigation And The Supreme Court: The …

(8 days ago) WEBThis article discusses the holdings and implications of Supreme Court decisions through June 21, 2022 focusing on Medicare payment cuts to 340B hospitals, employers’ coverage of dialysis

https://www.healthaffairs.org/content/forefront/health-related-litigation-and-supreme-court-2021-term-part-1

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Reforming How Medicare Pays for Digital Health - Bill of Health

(5 days ago) WEBCongress has an opportunity to reform Medicare in 2024, when the Trust Fund will become insolvent. Policymakers expect Congress to address this problem …

https://blog.petrieflom.law.harvard.edu/2021/08/11/medicare-digital-health/

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SCOTUS considers a Medicaid patient's right to sue the …

(3 days ago) WEBAn Indiana man's family sued a state-owned nursing home for alleged mistreatment. A U.S. Supreme Court decision in the case could determine the right of many Americans to sue government agencies.

https://www.npr.org/sections/health-shots/2022/11/06/1133947431/scotus-nursing-home-case-could-limit-right-to-sue

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How a Supreme Court case over federal power could affect U.S.

(2 days ago) WEBA Supreme Court hearing on a case that could significantly curtail the federal government's regulatory power has big implications for America's health care system.. …

https://www.axios.com/2024/01/17/supreme-court-chevron-deference-medicare-medicaid

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HHS Statement Regarding the Cyberattack on Change Healthcare

(7 days ago) WEBFOR IMMEDIATE RELEASE March 5, 2024. Contact: HHS Press Office 202-690-6343 [email protected]. HHS Statement Regarding the Cyberattack on Change Healthcare. …

https://www.hhs.gov/about/news/2024/03/05/hhs-statement-regarding-the-cyberattack-on-change-healthcare.html

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Feds Make Arrests in $1.2 Billion Medicare Fraud Cases - AARP

(3 days ago) WEBIn what was called one of the largest health care fraud schemes in U.S. history, federal officials on Tuesday announced a crackdown against 24 people charged …

https://www.aarp.org/money/scams-fraud/info-2019/feds-crackdown-medicare-fraud.html

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CMS Finalizes Physician Payment Rule that Advances Health Equity

(6 days ago) WEBContact: HHS Press Office 202-690-6343 [email protected]. CMS Finalizes Physician Payment Rule that Advances Health Equity. Final policies will expand …

https://www.hhs.gov/about/news/2023/11/02/cms-finalizes-physician-payment-rule-advances-health-equity.html

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UPCODING MEDICARE: IS HEALTHCARE FRAUD AND ABUSE …

(3 days ago) WEBIntroduction. Medicare fraud has been defined by the Centers for Medicare and Medicaid Services (CMS) as submitted or caused to have been submitted, false …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649706/

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False Claims Act judgments for healthcare totaled $1.8 billion in …

(3 days ago) WEBOne of the highest-profile cases involved Cigna, which agreed to pay $172 million to resolve allegations that it knowingly submitted and failed to withdraw …

https://www.healthcarefinancenews.com/news/false-claims-act-judgments-healthcare-totaled-18-billion-2023-doj-says

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CMS Issues Final Ruling to Impact FQHCs and RHCs for 2024

(1 days ago) WEBFrom January 1, 2023, through December 31, 2023, the FQHC PPS base payment rate is $187.19. On November 2, 2023, the Centers for Medicare and …

https://www.withum.com/resources/cms-issues-final-ruling-to-impact-fqhcs-and-rhcs-for-2024/

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Appealing Health Plan Decisions CMS

(8 days ago) WEBThe rules issued by the Departments of Health and Human Services, Labor, and the Treasury give consumers: The right to appeal decisions made by their health plan …

https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/appealing-health-plan-decisions

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Community Health Systems hospitals under DOJ investigation - STAT

(3 days ago) WEBCHS, a national system of 71 rural and suburban hospitals, said this week it received a civil investigative demand from the Department of Justice on Jan. 11. Federal …

https://www.statnews.com/2024/02/22/community-health-systems-hospitals-doj-billing/

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Cases - Center for Medicare Advocacy

(3 days ago) WEBJustice in Aging and the Center for Medicare Advocacy, along with pro bono firm Stinson, LLP, filed the case in February 2021. Read the complaint. On October 13, 2021, the …

https://medicareadvocacy.org/litigation/active-cases/

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Home Healthcare Company Settles False Claims Act Violations

(7 days ago) WEBRecently, DOJ has seen several cases of alleged False Claims Act violations and Medicare fraud. A California doctor was sentenced to prison for nearly …

https://revcycleintelligence.com/news/home-healthcare-company-settles-false-claims-act-violations

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Home health agencies threaten lawsuits over CMS payment …

(4 days ago) WEBCMS switched up its case-mix system in the the Patient-Driven Groupings Model last year, basing pay rates on patient characteristics like clinical conditions and …

https://www.modernhealthcare.com/payment/home-health-agencies-threaten-lawsuits-over-cms-payment-changes

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If Social Security not fixed, retirees face automatic cut in 2033 : NPR

(6 days ago) WEBMedicare and disability solvency. Still, the program, which provides health care for nearly 67 million people, is expected to face its own cash crunch in 2036. Social …

https://www.npr.org/2024/05/06/1249406440/social-security-medicare-congress-fix-boomers-benefits

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List of Telehealth Services CMS

(2 days ago) WEB3.0%. $20.60. Oct. 1, 2001 to Dec. 31, 2002. NA. $20.00. Page Last Modified: 12/18/2023 09:52 PM. Help with File Formats and Plug-Ins. List of services …

https://www.cms.gov/medicare/coverage/telehealth/list-services

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House committee passes Medicare telehealth extension bill

(Just Now) WEBHealth systems urge Congress to lay down a permanent road map for telehealth services as clock ticks on December deadline. In July, the Senate Finance …

https://www.fiercehealthcare.com/regulatory/house-ways-means-committee-reveals-two-year-telehealth-extension-legislation

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Navigating Insurance and Costs for Ambulatory Surgery - US …

(3 days ago) WEBIn many cases, the amount Medicare will ask patients to pay will be less than what it would cost in a hospital outpatient setting. For instance, the reimbursement for …

https://health.usnews.com/best-ascs/articles/how-do-ambulatory-surgery-centers-bill

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Nondiscrimination in Health Programs and Activities

(5 days ago) WEBExamples of health insurance coverage or other health-related coverage subject to the 2020 Rule (and thus the benefit design provisions under § 92.207(b)(1) …

https://www.federalregister.gov/documents/2024/05/06/2024-08711/nondiscrimination-in-health-programs-and-activities

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CMS issues proposed rule for mandatory organ transplant …

(3 days ago) WEBThe Centers for Medicare & Medicaid Services May 8 released a proposed rule for the Increasing Organ Transplant Access Model, a new payment model that …

https://www.aha.org/news/headline/2024-05-08-cms-proposed-rule-increasing-organ-transplant-access-model

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AHA urges Senate Budget Committee to streamline prior …

(4 days ago) WEBIn a statement submitted May 8 for a Senate Budget Committee hearing on reducing administrative burden in health care, AHA urged Congress to streamline the …

https://www.aha.org/news/headline/2024-05-08-aha-urges-senate-budget-committee-streamline-prior-authorization-process-hearing-reducing

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1 lawmaker stops South Carolina health care consolidation bill that …

(5 days ago) WEBThe bill follows up last year’s breakup of the state Department of Health and Environmental Control that spun off the environmental functions. The 2024 proposal …

https://apnews.com/article/south-carolina-health-care-consolidation-bill-3b5d175a228ee63dc35e84897d8be392

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Gov. Reynolds signs bill extending postpartum health care and …

(5 days ago) WEBToday, Governor Kim Reynolds signed Senate File 2251, a bill for an act relating to eligibility for pregnant women and infants under the Medicaid program, and …

https://governor.iowa.gov/press-release/2024-05-08/gov-reynolds-signs-bill-extending-postpartum-health-care-and-several-other-bills-law

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Casey, Colleagues Introduce Bill to Address Maternal Health Crisis

(8 days ago) WEBThe Mamas First Act would expand Medicaid to cover doula care and midwifery. Washington, D.C. - Today, U.S. Senators Bob Casey (D-PA), Elizabeth …

https://www.casey.senate.gov/news/releases/casey-colleagues-introduce-bill-to-address-maternal-health-crisis-expand-coverage-of-doula-care

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Louisiana lawmakers reject adding exceptions of rape and incest to

(Just Now) WEBDemocratic lawmakers in Louisiana are pushing bills to add exceptions, including in cases of rape and incest, to the state’s near-total abortion ban. A GOP …

https://apnews.com/article/abortion-incest-rape-louisiana-exception-846480b677fbc6fbe60d18ca13572899

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Missouri's GOP Gov. Parson signs bill to kick Planned Parenthood …

(3 days ago) WEBJEFFERSON CITY, Mo. (AP) — Missouri’s Republican Gov. Mike Parson on Thursday signed legislation to once again try to kick Planned Parenthood out of the …

https://apnews.com/article/missouri-planned-parenthood-medicaid-defund-5049f0356a7c4ba09d8aea035d55ef6d

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