First Enforcement Actions on Price Transparency Compliance
Remember to register for the complimentary SAI Global Webinar on “Evidencing Compliance Program Effectiveness (sai360.com),” which will be held on…
GAO Data Breach Reporting Survey
In response to a congressional request, the Government Accountability Office (GAO) launched a survey of health care entities and business…
CMS and VA Announce Partnership to Address Fraud, Waste, and Abuse.
The Department of Veterans Affairs (VA) and the Centers for Medicare & Medicaid Services (CMS) recently announced a partnership designed…
Massachusetts’s State Auditor Finds $193 Million in Improper Behavioral Health Payments by MassHealth.
Massachusetts’s State Auditor recently audited the behavioral health program at MassHealth. The audit found that MassHealth paid doctors directly for…
CMS Issues Fines against 17 Insurers for Medicare Prescription Drug Rules Violation.
The Centers for Medicare and Medicaid Services (CMS) recently fined 17 health plans for violating Medicare prescription drug rules. CMS…
President of Transportation Company Sentenced to Prison for Role in $70 Million Health Care Fraud Scheme.
The Department of Justice (DOJ) recently announced that the President of Transportation Service Providers Inc. was sentenced to 60 months…
DOJ Announces $250 Million False Claims Act Settlement for Improper Cardiac Device Implantation.
The United States Department of Justice (DOJ) announced that it reached 70 settlements with 457 hospitals to resolve alleged violations…
CMS Announces Changes to Two Midnight Rule Probe and Educate Reviews.
The Centers for Medicare & Medicaid Services (CMS) announced that Quality Improvement Organizations (QIOs) will assume responsibility from the Medicare…
DaVita to Pay $450 Million in Settlement Regarding Reimbursement for Unnecessary Drug Wastage.
DaVita Healthcare Partners, Inc., the largest dialysis services provider in the United States, has agreed to pay the government $450…
National Medicare Fraud Takedown Uncovers $712 Million in False Billing.
A recent Medicare Fraud Strike Force takedown in 17 districts resulted in Medicare fraud charges against 243 individuals, including 46…
IRS and Treasury Department Issue Final Rule on Requirements for Charitable Hospitals.
The Internal Revenue Service (IRS) and U.S. Department of the Treasury issued a final rule under Section 501(r) of the…
CMS Announces Updates to the Recovery Audit Program.
On December 30, 2014, the Centers for Medicare & Medicaid Services (CMS) announced new Recovery Audit contracts and updates to…