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Search results for: “reimbursement”
The Shocking Truth About Neurostimulators and the Government’s Efforts to Recoup Payments
For much of the past decade, peripheral neurostimulator devices have been used liberally by some practitioners to treat chronic pain. In addition to pain relief, any…
The Facts About Medical Factoring
One of the immutable truths about healthcare is that it can take a long time to get paid. Though Texas has a prompt payment statute,8 it…
Texas Company Agrees to Reimburse Medicare for Improper Billing Related to Neurostimulators
Spinal Decompression Clinic of Texas (“SDCT”) has agreed to pay $330,898.00 to resolve liability under the False Claims Act for the alleged improper billing of electro-acupuncture…
Texas, Pennsylvania hospitals lose lawsuit challenging Medicare payments
The hospitals said HHS wrongly calculated their Medicare disproportionate share hospital payments for fiscal year 2015, using the wrong data. As a result, the hospitals appealed…
The United States and Tennessee Resolve False Claims Act Claims Relating to “P-Stim” Devices
A physician and two chiropractors agreed to pay the United States and Tennessee a total of $1.72 million to resolve liability under the False Claims Act…
Two area home health agency owners charged in health care fraud and illegal kickback scheme
A federal grand jury indicted two home health agency on allegations that they fraudulently billed Medicare more than $10 million. The indictment alleges that Tataw and…
Direct Contracting Model Comes to Medicare
Under the model, healthcare providers — which CMS calls “direct contracting entities,” or DCEs — will competitively bid to manage 100% of the Medicare Part A…
Stark + AKS Final Rules
The final rules for changes to the Stark Law and Anti-Kickback Statute (healthcare fraud & abuse laws) have been published and go into effect on January…
San Antonio ER hospital sued for alleged overbilling
A former patient has sued Baptist Emergency Hospital in San Antonio and its owner alleging they fraudulently overcharged for lab work to generate higher reimbursements. This…
DOJ sues Cigna, alleging $1.4B in Medicare Advantage fraud
Cigna falsified the health conditions of its Medicare Advantage plan members to coax CMS into making larger payments to the insurer on behalf of beneficiaries, a…