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Information
U.S. attorneys turn up heat on healthcare fraud
By Associated Press | July 27, 2014
The top federal prosecutors from South Dakota and North Dakota say they have increased their efforts to fight healthcare fraud.
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Magazine
Fictitious applicants easily get ACA subsidies: GAO
By Paul Demko | July 26, 2014 | Print Magazine Print Magazine Subscription Details
While federal courts last week ruled on the legality of insurance subsidies issued from federally run exchanges, Congress was hearing about another, much more dollars-and-cents subsidy issue, namely how easy it apparently is for consumers to lie to obtain subsidies.
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Information
Invoking anti-fraud law, Louisiana doctor gets rich
By Wall Street Journal | July 24, 2014
William LaCorte keeps a half-dozen marble paperweights at his medical practice in Metairie, La., engraved with images of checks from a lucrative sideline: suing companies for alleged healthcare fraud. Dr. LaCorte is a so-called serial whistle-blower, one of the more-prolific plaintiffs among a...
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News
Bogus exchange applications resulted in coverage, GAO says
By Paul Demko | July 23, 2014 | Basic Web Basic Web Subscription Details
A day after federal appellate courts issued conflicting rulings about whether individuals who obtain coverage through the federal exchange are eligible for subsidies, a House subcommittee heard about another aspect of health insurance subsidies, namely that it's apparently easy to obtain them under...
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News
Halifax Health to pay $1 million settlement in widely watched False Claims case
By Joe Carlson | July 14, 2014 | Basic Web Basic Web Subscription Details
One of the most widely watched False Claims Act cases filed against a hospital is quietly approaching an end—Florida's Halifax Health is preparing to pay $1 million to settle an alleged $73 million Medicare overbilling case.
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Magazine
Better rules needed to boost use of big data
By Merrill Goozner, Editor | July 12, 2014 | Print Magazine Print Magazine Subscription Details
It's easy to get swept up in the swelling enthusiasm for using the explosion in electronic health and claims records to improve every aspect of healthcare. But the era of “big data” isn't going to happen without better federal rules for stimulating its uses and preventing abuses.
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News
Dubious Medicare billing found at clinical labs
By Bob Herman | July 09, 2014 | Basic Web Basic Web Subscription Details
Medicare doled out $8.2 billion in Part B payments to clinical laboratories in 2010, but more than 20% of those payments came from claims tied to questionable billing patterns, according to a government report.
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Vital Signs
No upcoding caused by EHRs – yet, study finds
By Darius Tahir | July 08, 2014
For every technology, there's a downside—and for EHRs, one of the buzzed-about downsides was the supposed ease of upcoding: the practice of selecting the most remunerative code for a particular procedure.
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Information
Missouri governor vetoes health navigator limits
By Associated Press | July 08, 2014
Missouri Gov. Jay Nixon vetoed legislation Monday that would have limited who could work in the state as a health insurance guide and blamed a national conservative group for injecting an error into the model legislation.
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Information
Dr. Oz scolded at hearing on weight loss scams
By Associated Press | June 18, 2014
Under pressure from Congress, celebrity physician Mehmet Oz on Tuesday offered to help "drain the swamp" of unscrupulous marketers using his name to peddle so-called miracle pills and cure-alls to millions of Americans desperate to lose weight.
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