Archive
Wade Emmert
Next-Gen Weight-Loss Drugs Receive Tentative Embrace by Medicaid
Medicare does not currently cover Wegovy or other medications specifically for obesity. But some Medicaid programs, which are administered by individual states, are negotiating discounts for…
Think Like a Prosecutor: How Physicians Can Address the Threat of Data Mining-Based Fraud Investigations
Dan Martin, for Medical Economics: When you deviate from your peers, be especially sure to document the legitimate reasons for that deviation. Expect that insurance companies,…
OIG: HRSA Made Improper Payments Through COVID-19 Uninsured Program
Victoria Bailey, for RevCycle Intelligence: The COVID-19 Uninsured Program, administered by HRSA, allowed providers to enroll and submit claims for reimbursement of COVID-19 testing and treatment…
U.S. Supreme Court Clarifies DOJ’s Authority to Dismiss Whistleblowers’ False Claims Act Suits, Questions Constitutionality of Qui Tam Provisions
Edwin O. Childs, Michael J. Podberesky, Jonathan Ellis, Gretchen Heinze Townshend, Todd R. Steggerda, Charles Wm. McIntyre and Jason M. Vespoli, for The FCA Insider -…
Stark Law Changes Ramp Up in 2023
Patsy Newitt, for Becker’s ASC Review: The Consolidated Appropriations Act of 2023 updated exceptions to Stark law and anti-kickback law that will allow hospitals and healthcare…
Collin County Man Sentenced for Federal Violations Related to Health Care Fraud Scheme
Press Release for the Eastern District of Texas: Oscar Simon Ndereva, 45, pleaded guilty to wire fraud and was sentenced to 54 months in federal prison…
Period of Enhanced Oversight for New Hospices in Arizona, California, Nevada, & Texas
CMS is placing newly enrolling hospices located in Arizona, California, Nevada, and Texas in a provisional period of enhanced oversight. Over the last 12 months, we’ve…
Just More Than a Third of Hospitals Are Complying with Price Transparency Rules
Joseph Choi, for The Hill: More than two years after federal hospital price transparency rules went into effect, only about a third of hospitals are currently…
Pain Management Physician’s Assistant Charged in Amniotic Fluid Scam
Press Release for U.S. Attorney’s Office, Northern District of Texas: Certain amniotic products have been approved by the U.S. Food and Drug Administration for wound care,…
FTC Follows DOJ and Withdraws Antitrust Policy Statements
Charles Honart, for Stevens & Lee: On July 14, the Federal Trade Commission (“FTC”), as anticipated, announced that it was withdrawing two antitrust policy statements related…