The U.S. Department of Justice has circulated an internal memo signaling that it may intervene—by seeking dismissal—in more lawsuits brought under the federal False Claims Act's qui tamprovisions. Those provisions allow “whistleblowers” to file suit on the government’s behalf and receive a portion of damages. They are aimed at reining in fraud involving government programs such as Medicaid.
Fresenius Medical Care North America (FMCNA) will pay $3.5 million to the U.S. Department of Health and Human Services (HHS) Office for Civil Rights to settle Health Insurance Portability and Accountability Act violations. FMCNA also will adopt a “comprehensive corrective action plan,” according to an HHS press statement.
On February 2, the Department of Health and Human Services announced that it approved a waiver request by the state of Indiana to include work requirements in its Healthy Indiana Plan. This comes on the heels of approved changes to Kentucky’s Medicaid program, which also instituted work requirements.
A federal district court judge denied a preliminary injunction against cuts to the Medicare 340B rule that was finalized in November. Judge Rudolph Contreras of the Federal District Court for the District of Columbia ruled on Dec. 29, 2017, denying the motion filed by the American Hospital Association (AHA) and other stakeholders.
The Centers for Medicare & Medicaid Services recently announced its updated Hospital Compare star rating system. The agency had postponed the release of the ratings for more than five months to address the concerns of some stakeholder hospitals that the previous star formulas were flawed.
Pharmaceutical company United Therapeutics (UT) has agreed to pay $210 million for False Claims Act and Anti-Kickback Statute claims against them. The government alleged that UT used a foundation as a conduit to pay the copays of Medicare patients taking UT drugs.
Failing to protect the health information of millions of patients in violation of HIPAA has led to 21st Century Oncology Inc. settling with the Office of Civil Rights division of the Department of Health and Human Services to pay civil monetary penalties.
The United States Government Accountability Office (GAO) has asked the Centers for Medicare and Medicaid Services to improve its recognition and enforcement of antifraud, waste, and abuse efforts and to align with the GAO’s Fraud Risk Framework and the Fraud Reduction and Data Analytics Act of 2015.