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Supreme Court ruling potentially expands false claims liability for healthcare providers

In a much-anticipated decision, the U.S. Supreme Court ruled recently that the implied false certification theory may form the basis for liability under the False Claims Act (FCA), resolving a split of among the federal...more

OIG rules hospital's offer of free transportation, lodging doesn't violate anti-kickback statute

The Office of Inspector General of the Department of Health and Human Services recently posted an Advisory Opinion describing a proposed arrangement by an academic medical center that offers free transportation and lodging to...more

Hospital-Physician Alignment

Hospital-physician alignment involves the effective coordination between physicians and hospitals in order to accomplish and prioritize patient care and financial goals. Those goals may relate to better patient-centered care,...more

3/3/2015  /  Healthcare , Hospitals , Physicians

CMS authorizes contractors to deny ‘related’ claims of physicians who are not undergoing review

The Centers for Medicare and Medicaid Services (CMS) of the Department of Health and Human Services recently issued Transmittal 505 modifying Section 3.2.3 of the Medicare Program Integrity Manual. CMS employs a variety of...more

3/7/2014  /  CMS , Contractors , Healthcare , MACs , Medicare , Physicians , ZPIC

OIG rejects management arrangement that carves out federal healthcare program patients

The Office of Inspector General of the Department of Health and Human Services recently posted an Advisory Opinion describing a proposed arrangement by a clinical laboratory. ...more

Court rules employers who provide services to federal government employees subject to federal contracting regulations

A federal court recently ruled that hospitals affiliated with the University of Pittsburgh Medical Center became “federal subcontractors” when they entered into contracts with an HMO that provided health services for federal...more

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