Program Integrity
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
By understanding the areas of new and enhanced program integrity focus required by the Patient Protection and Affordable Care Act of 2010 (ACA) as well as existing program integrity initiatives, hospitals will be better able to prepare for the greater oversight of their activities that is almost…