Search results for: “reimbursement”

The Justice Department charged 455 defendants, including 90 doctors and licensed medical professionals, in the 2026 National Health Care Fraud Takedown tied to more than $6.5…

OIG Advisory Opinion No. 26-14 grants a favorable determination to a pharmaceutical manufacturer sponsoring free antibody testing to identify patients potentially eligible for its drug. Under…

CMS has proposed a rule that would cut $774.8 billion in state and federal Medicaid spending over 10 years by capping State Directed Payments (SDPs), far…

CMS has imposed six-month, nationwide moratoria on new Medicare enrollment for hospices and home health agencies, blocking both initial enrollment applications and certain changes in majority…

The Justice Department’s Civil Division launched the FOCUS (Fraud Oversight through Careful Use of Statistics) initiative to formalize its relationship with data miners filing qui tam…

Fragmented identity systems across healthcare force patients to maintain separate credentials for patient portals, EHRs, pharmacies, PBM claims platforms, and insurer authorization — multiplying security risks…

The HHS Office of Inspector General will not impose sanctions on a Medicare Advantage organization that proposes to share a percentage of its savings with employer…

Private equity firms have invested over $1 trillion in debt-financed healthcare transactions over the past decade, with 93% of healthcare companies carrying speculative debt being private…

The U.S. Department of Justice recovered more than $6.8 billion in False Claims Act settlements and judgments in fiscal year 2025, marking the largest annual total…

The OIG issued a favorable advisory opinion allowing a medical device manufacturer to subsidize Medicare cost-sharing obligations for patients enrolled in a clinical trial testing an…