Claims & Litigation
A Minnesota state court April 15 dismissed a lawsuit filed by PhRMA challenging the state’s law protecting 340B pricing for contract pharmacy arrangements.
The Healthcare Equality Network July 3 sent a letter to the Centers for Medicare & Medicaid Services, expressing concerns about claims denials by commercial insurance companies.
The Department of Labor July 31 sued a third-party administrator owned by UnitedHealth Group in the U.S. District Court for the Western District of Wisconsin, alleging it improperly denied claims for emergency services and urinary drug screening since 2015.
The New Hampshire Hospital Association recently released a report highlighting the challenges New Hampshire hospitals and health systems face in dealing with Anthem, the state’s largest insurance provider, including nearly $300 million in unprocessed claims for services provided by New Hampshire…
An arbitrator has ordered that Anthem Insurance Company, Inc. (“Anthem”) pay a group of 11 acute care hospitals in Indiana (“hospitals”) $4.5 million as compensation for adopting a policy of processing claims for emergency services that the arbitrator found is a “clear” violation of federal and…
The Department of Justice this week issued formal guidance on how it awards credit to defendants who cooperate during a False Claims Act investigation.
Today's Appeals Court decision moves the hospital field closer to getting relief for timely reviews of Medicare claims denials, which they asked for more than a year ago.
The American Hospital Association (AHA) is pleased to support your legislation, the Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082), to delay enforcement of the Medicare inpatient admission and review criteria (the two-midnight policy).