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.
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.
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.”
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 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.
Allergan Inc. will pay $3.5 million to resolve allegations brought against it under the False Claims Act. The allegations surround Allergan’s LAP-BAND device, which is used by physicians to assist obese patients with weight reduction.
In March, the Centers for Medicare and Medicaid Services (CMS) announced a new initiative called “MyHealthEData,” designed to allow patients to control their own health data and make it portable from provider to provider. In late April, CMS announced a “Data Driven Patient Care Strategy” to advance that initiative.