On November 6, 2023, OIG released new General Compliance Program Guidance (General CPG). The General CPG applies to all individuals and entities involved in the healthcare industry. The release of the General CPG was not...more
On November 8, 2019, the Department of Justice (DOJ) announced a settlement with a New York hospital for $12.3 million in connection with alleged improper overlapping and concurrent urology surgeries performed by one...more
On June 4, 2018, the United States Court of Appeals for the Fourth Circuit affirmed the dismissal of antitrust claims brought by Providence Hospital alleging that Palmetto Health carried out an anticompetitive scheme to...more
On February 9, 2018, the U.S. Department of Justice (DOJ) announced it reached a proposed settlement with Henry Ford Allegiance Health (Allegiance) over allegations that Allegiance conspired with rival hospitals to engage in...more
In December 2017, the Medicare Payment Advisory Commission (MedPAC) issued a report to Congress analyzing the impact of physician supervision requirements in critical access hospitals (CAHs) and small rural hospitals. ...more
Last week, HHS OIG released a report finding that Medicare inappropriately paid acute-care hospitals for outpatient services provided to beneficiaries who were inpatients of other facilities, such as long-term care hospitals,...more
On February 8, 2017, the United States District Court for the District of Connecticut declined to fully dismiss allegations filed by a class of Medicare patients against HHS in Alexander et al. v. Cochran (formerly Bagnall et...more
On December 6, 2016, Senate Finance Committee Chairman Orrin Hatch (R-Utah) and Ranking Member Ron Wyden (D-Ore.) issued a Committee staff report detailing concurrent and overlapping surgery practices. The report also offers...more
On November 3, 2016, CMS announced details for a new Hospital Appeals Settlement program to permit eligible providers to settle certain inpatient status claims currently under appeal. According to CMS, the purpose of the 2016...more