The Centers for Medicare and Medicaid Services is seeking input from the public on how the physician self-referral law, or Stark Law, may be affecting the coordination of care for federally funded patients.
The U.S. Government Accounting Office recently released a study of the Medicare prior authorization program, which is used by private health insurers. The program requires providers and suppliers to demonstrate compliance with coverage and payment rules before patients receive a given service or item.
Pharmaceutical company Pfizer Inc. will pay $23.85 million to settle False Claims Act allegations that it induced Medicare patients to purchase its drugs via a “charitable foundation” that funded copays. Such an arrangement violates the Anti-Kickback Statute.
The Centers for Medicare and Medicaid Services (CMS) has agreed to extend and update Maryland’s all-payer model. CMS describes that model — the only of its kind in the United States — as one in which “all third parties pay the same [hospital] rate.”
CityMD, an urgent care center chain with locations in New York, New Jersey, and Washington, D.C., recently admitted responsibility for conduct that led to False Claims Act allegations brought against it in the Southern District of New York.