The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) estimates that investigative recoveries would be more than $2 billion for the first half of fiscal year (FY) 2017, according to the agency’s Semiannual Report to Congress.
EClinicalWorks (ECW), one of the nation’s largest vendors of electronic health records (EHRs), has agreed to pay $155 million dollars to settle False Claims Act (FCA) allegations. The Department of Justice (DOJ) alleged that ECW misrepresented the capabilities of its software, and paid kickbacks to certain customers in exchange for promoting its product.
The United States Supreme Court has ruled 8-0 that church-affiliated hospitals are exempt from the requirements of the Employee Retirement Income Security Act (ERISA). ERISA is a 1974 law that protects employees who participate in pension plans.
The Centers for Medicare & Medicaid Services recently issued new proposed rules regarding payment and policy for skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), and Hospice providers.
The Department of Justice (DOJ) recently announced the $6 million settlement of kickback allegations against Quest Diagnostics. The original allegations were filed as a qui tam whistleblower False Claims Act (FCA) lawsuit against Berkeley HeartLab, which was acquired by Quest in 2011.
The Office of Inspector General (OIG) has issued a review of the Centers for Medicare & Medicaid Services (CMS) oversight and efforts to ensure the quality of the Inpatient Quality Reporting (IQR) data. OIG recommends that CMS use additional tools to identify anyone gaming the system.
The Centers for Medicare & Medicaid Services (CMS) introduced its Accountable Health Communities (AHC) model, an innovation to address the gap they say exists between clinical care and community services.