On October 1, 2013, Kentucky will officially launch its health insurance exchange, Kynect, which is one of the key components in Kentucky's efforts to implement the Patient Protection and Affordable Care Act. Kynect is a…more
The Office of Inspector General (OIG) recently issued an Advisory Opinion on the legality of a co-management compensation arrangement between a hospital and a physician group.
The opinion describes a rural acute care hospital…more
The Centers for Medicare and Medicaid Services (CMS) recently released the long-awaited final rule that implements the Physician Payment Sunshine Act.
The Sunshine Act required drug, medical device, and other manufacturers to…more
The U.S. Department of Health and Human Services' Office of Inspector General (OIG) recently released its Work Plan for Fiscal Year 2013. Annually, OIG releases the plan to identify the projects it intends to undertake and the…more
The Centers for Medicare and Medicaid Services (CMS) has released its final rule on the Stage 2 requirements for the electronic health record (EHR) incentive program.
Under the EHR program, providers can qualify for Medicare…more
The Department of Health and Human Services (HHS) has announced a new public-private initiative aimed at preventing healthcare fraud.
Under the new plan, insurance companies and providers will trade billing information with…more
Among the changes the Affordable Care Act (ACA) will bring to providers of health care are new requirements for hospitals to retain or to be granted status as a 501(c)(3) organization.
The provisions - § 501(r)(3) through (6)…more
The U.S. Supreme Court voted last week to uphold the Patient Protection and Affordable Care Act ("ACA"), bringing an end to a long and hard-fought legal battle between the Obama Administration and a host of plaintiffs.
A final rule released last month by the Centers for Medicare and Medicaid Services (CMS) has made significant substantive changes to hospital governance requirements.
The final rule will allow a single governing body to…more
The Department of Health and Human Services Office of Inspector General ("OIG") issued an Advisory Opinion last week in which it stated that two provider proposals with physician-owned ambulatory surgery centers ("ASCs") could…more
The Centers for Medicare and Medicaid Services (CMS) has delayed the data collection mandated by the Physician Payments Sunshine Act until January 1, 2013.
The Sunshine Act required drug, medical device, and other…more
Forty-three Roman Catholic institutions - including the University of Notre Dame - and 13 dioceses sued the Department of Health and Human Services (HHS) this week in an effort to halt the implementation of a rule requiring…more
The Government Accountability Office (GAO) has reported that the Centers for Medicare and Medicaid Services (CMS) could be doing more to ensure its incentive payments under the electronic health record (EHR) program are proper…more
A nationwide Department of Health and Human Services (HHS) operation has netted indictments against 107 individuals in a seven-city, $452 million Medicare false billing scheme.
It was the highest amount of false Medicare…more
In Fiscal Year 2011, the U.S. Department of Justice recovered more than $3 billion as a result of False Claims Act (FCA) settlements and judgments. On September 7, 2011, DOJ arrested ninety-one people in eight states and…more
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