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Community Health Systems unit settles false-billing case for $262M

Community Health Systems unit settles false-billing case for $262M

By Alex Kacik  |  September 25, 2018

Health Management Associates allegedly billed government healthcare programs for inpatient services that should have been billed as outpatient or observation, paid physicians for patient referrals and submitted inflated claims for ER facility fees.

California: Drugmaker paid doctors to overprescribe Humira

California: Drugmaker paid doctors to overprescribe Humira

By Associated Press  |  September 19, 2018

California's insurance commissioner accused pharmaceutical giant AbbVie of illegally plying doctors with cash, gifts and services to prescribe Humira, tainting their relationship with patients and driving up insurance costs.

Hospitals give CMS their Stark law wish list

Hospitals give CMS their Stark law wish list

By Virgil Dickson  |  August 29, 2018

The CMS has received more than 300 suggestions on how it can reduce the burden of anti-kickback laws on providers, ranging from revising what is considered a referral to giving providers protection for unintentional violations.

Update the Stark law now, HHS and providers tell Congress

Update the Stark law now, HHS and providers tell Congress

By Virgil Dickson  |  July 17, 2018

Providers and a top HHS official Tuesday urged Congress to loosen the Stark law's restrictions. The move to value-based care models could be undermined if the 30-year-old law isn't changed.

CMS seeks information to reduce Stark law burden

CMS seeks information to reduce Stark law burden

By Virgil Dickson  |  June 20, 2018

The CMS has issued a request for information to review how it can reduce the burden around the controversial Stark law. Providers claim the law has slowed the move to value-based care.

Azar tells hospitals ACO models will get easier

Azar tells hospitals ACO models will get easier

By Susannah Luthi  |  May 09, 2018

Some providers believe HHS Secretary Alex Azar will ease provider self-referral restrictions that they say inhibit physicians and hospitals from building accountable care organizations.

Now it's personal: Top execs made to pay for companies' false claims

Now it's personal: Top execs made to pay for companies' false claims

By Erica Teichert  |  October 01, 2016

Last year, U.S. Deputy Attorney General Sally Quillian Yates warned top healthcare executives they would be held personally accountable for false Medicare and Medicaid claims and illegal physician relationships. She was serious.

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