Hospital May Have Liability Under Consumer Law or for Negligent Credentialing
December 28, 2012
A hospital could be held liable for violating a state consumer protection law for entrepreneurial, commercial, or business actions, according to a recent decision by the...
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Federal Court Dismisses Relator Lawsuit Alleging False Claims for Hospital Failure to Provide Direct Supervision of Outpatient Cardiac and Pulmonary Rehabilitation Services
December 28, 2012
On December 14, 2012, the United States District Court, District of Minnesota, dismissed a qui tam relator lawsuit alleging that a hospital violated the federal False...
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WakeMed Agrees to $8 Million Settlement for Wrongful Medicare Billing Practices
December 28, 2012
North Carolina-based WakeMed Health & Hospitals has agreed to pay an $8 million settlement to the U.S. Department of Justice ("DOJ") in order to resolve a...
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FDA Signs Statement of Cooperation Regarding Medical Device Auditing with Brazil, Australia, and Canada
December 27, 2012
On November 27, 2012, the FDA signed a statement of cooperation ("SOC") with the food and drug administration agencies of Brazil (the Brazilian Health...
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CMS Clarifies Medicare Requirements Regarding Progress Notes and Templates, and Corrections and Delayed Entries in Medical Records
December 27, 2012
In Transmittal 438 (Change Request 8033 (Nov. 9, 2012)), CMS revised Medicare Program Integrity Manual (100-08), Chapter 3, Section 3.3.2.1.1, "Progress Notes and...
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Court of Federal Claims Says Medicare Providers May Not Sue the Government for Breach of Contract over Regulatory Violations But May Pursue Takings Claims
December 26, 2012
The U.S. Court of Federal Claims recently held that a company that is allowed to bill Medicare for services it provides does not necessarily have a contract with the...
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Report Finds Over 4,000 Physician “Never Events” Per Year
December 26, 2012
Each year, U.S. surgeons make more than 4,000 preventable mistakes known as "never events" according to a Johns Hopkins University School of Medicine study...
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GAO Report Recommends CMS Coordination of Innovation Programs
December 25, 2012
On December 17, 2012, the Government Accountability Office ("GAO") published a report assessing Center for Medicare and Medicaid Innovation (the "Innovation...
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Obama Administration and Congress Fail to Reach Agreement Avoiding the Fiscal Cliff
December 24, 2012
As of December 21, 2012, the Obama Administration and Congress have failed to reach an agreement to avoid the so-called "fiscal cliff," under which in January...
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GAO Report Recommends Expanded Use of Prepayment Edits
December 20, 2012
On November 13, 2012, the Government Accountability Office ("GAO") published report GAO-13-102, "Greater Prepayment Control Efforts Could Increase Savings...
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CMS Issues Instructions for Clinical Diagnostic Laboratories that Bill Medicare
December 19, 2012
On November 30, 2012, CMS issued Change Request 8132 (Transmittal 2601), which provides instructions for the Calendar Year ("CY") 2013 clinical laboratory fee...
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GAO Report Recommends Reduced ESRD Prospective Payment Rate
December 19, 2012
On December 7, 2012, the Government Accountability Office ("GAO") published report GAO-13-190R, "Trends in ESRD Drug Utilization," in which the GAO...
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No Enhanced Funds for Partial Medicaid Expansions
December 18, 2012
The Centers for Medicare & Medicaid Services ("CMS") told states that they will not receive enhanced federal funding if they expand Medicaid at a level...
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CMS Reports on Success of Medicare E-Record Incentive Program; HHS Responds With Concerns About Fraud
December 18, 2012
Almost 75% of doctors in the United States are currently utilizing some form of electronic health records, according to data recently released by The Office of the...
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HHS Grants Conditional Approval to Six States’ Health Insurance Exchange Plans
December 17, 2012
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On December 10, 2012, Kathleen Sebelius, Secretary of the Department of Health and Human Services ("HHS"), announced that the government had conditionally...
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