Program Integrity
The Department of Health and Human Services’ Office of Inspector General today issued a final rule expanding its ability to exclude individuals or entities from federal health care programs, as authorized by the Affordable Care Act and other laws.
Beginning Dec. 1, the CMS will reopen settlement for certain inpatient status claims.
The Department of Health and Human Services late June 28, issued a proposed rule that would make changes to the procedures for Administrative Law Judge (ALJ) appeals of payment and coverage determinations for items and services provided to Medicare beneficiaries, in addition to other Medicare…
Supreme Court issues decision in False Claims Act case.
In a series of speeches the Assistant Attorney General for the Department of Justices Criminal Division announced that they are "stepping up" use of cases filed under the False Claims Act as a tool to investigate potential criminal activity.
RAC Cloud
The RAC Burden: How a Well-Intentioned Federal Program Has Become a Drain on Hospitals