Category Archives: Compliance

OCR Announces HIPAA Settlement and New FAQ on Business Associate Agreements.

The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) recently announced a settlement involving the failure to review and update a business associate agreement (BAA) under the Health Insurance Portability and Accountability Act (HIPAA).  Care New … Continue reading

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Medicare Wastes Billions on Defective Medical Devices, Audit Finds

Medicare’s fiscal watchdog has documented $1.5 billion in spending on seven types of defective heart devices that doctors implanted in thousands of beneficiaries. In addition to the money Medicare paid to health care providers for services and procedures related to … Continue reading

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Former American Senior Communities Executives Indicted

United States Attorney Josh J. Minkler announced the indictment of four individuals for their roles in a vast fraud, kickback, and money laundering scheme involving Indiana nursing home chain American Senior Communities (ASC).  Those charged include James Burkhart, 51, of Carmel, … Continue reading

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Tenet Medicaid Settlement Triggers Class Action Lawsuit

Dive Brief: A Tenet Healthcare shareholder filed suit in a California federal court, claiming the Dallas-based hospital chain misled investors about its financial health after a $514 million Medicaid kickback settlement came to light. The putative class action lawsuit, filed … Continue reading

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Feds Accuse Aetna, Humana of Trying to ‘Derail’ Antitrust Challenge

U.S. Justice Department lawyers, repudiating the misconduct allegations that Aetna Inc. and Humana Inc. raised in the government’s blockbuster antitrust suit, accused attorneys for the health insurers of a “transparent” push to unravel the case before it’s ever presented to … Continue reading

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Novartis Pays $35 Million to Settle False Claims Case

Novartis Pharmaceuticals Corporation has paid more than $35 million to resolve federal and state False Claims Act allegations resulting from the off-label marketing for Elidel. Elidel is a cream approved by the Food and Drug Administration to treat eczema in … Continue reading

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Ambulance Company Owner Sentenced to Prison

Bassem Kuran, 23, of Philadelphia, PA, was sentenced today to ten months in prison for making false statements to Medicare through VIP Ambulance, Inc., an ambulance company that Kuran owned and which he served as President. The Honorable Gerald J. … Continue reading

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ICD-10 turns 1: Was it so bad?

Gearing up for the switch from ICD-9 to ICD-10 last October, many providers expected nothing but headaches. The new system increased the number of diagnostic codes from around 13,000 to about 68,000, requiring clinicians to sift through highly specified conditions … Continue reading

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HHS Chief Hints at Tweaks to ObamaCare Marketplace

Health and Human Services (HHS) Secretary Sylvia Mathews Burwell on Wednesday sought to calm fears about the still-shaky ObamaCare marketplaces in the final stretch before this year’s sign-up period. Speaking to health insurance executives in Washington, Burwell stressed that the … Continue reading

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Tenet Settles Whistleblower Lawsuit for $513 Million

A major U.S. hospital chain, Tenet Healthcare Corporation, and two of its Atlanta-area subsidiaries will pay over $513 million to resolve criminal charges and civil claims relating to a scheme to defraud the United States and to pay kickbacks in … Continue reading

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