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Posts tagged with "Fraud"

Hospices Get 3.1% Pay Bump in 2024 Final Rule CMS Rules

Hospices Get 3.1% Pay Bump in 2024 Final Rule

Last Friday, the Centers for Medicare and Medicaid Services (CMS) published the final rule for the FY 2024 Hospice Payment Rate Update. Hospices will receive 3.1% pay bump, which will work out to roughly $780 million. According to the CMS Fact Sheet, the rule also raises the payment cap to $33,494.01. The agency also notes that it...
COVID-19 Update January 5, 2023 Arizona News

COVID-19 Update January 5, 2023

The U.S. has a new dominant COVID-19 variant, XBB.1.5, which is reportedly twenty-five times as contagious as the original strain of coronavirus. Meanwhile, seniors and people of color bear the burden of high rates of transmission and death as a result of the virus. New research demonstrates that the death toll of COVID-19 in...
Lawsuits Filed Against Nursing Homes, COVID-19 Waivers and Telehealth Fraud, Medicare and Medicaid Fraud National News

Lawsuits Filed Against Nursing Homes, COVID-19 Waivers and Telehealth Fraud, Medicare and Medicaid Fraud

As COVID-19 restrictions relax and business practices return to normal guidelines, a large number of negligence and wrongful death suits have been filed due to a repeal of liability protections and statutory deadlines. Johnson & Johnson was unable to overturn a ruling in a deceptive marketing case regarding transvaginal mesh...
Medicare Fraud Update: Telehealth Scheme, PBMs, Drug Price Fixing, The NFL and the NBA News

Medicare Fraud Update: Telehealth Scheme, PBMs, Drug Price Fixing, The NFL and the NBA

Throughout September and well into October, a large number of Medicare and Medicaid related fraud cases have come to public light. This week, it's time to double back on cases that have stayed in the wings for the past two months. In late September, the U.S. Department of Justice (DOJ) announced criminal charges for 42 providers...
National News

DOJ Joins Lawsuits Against Kaiser for False MA Claims

The U.S. Department of Justice has joined a series of six lawsuits that allege Kaiser Permanente knowingly submitted false Medicare Advantage claims. Kaiser allegedly pressured physicians to create addenda to medical records to add risk-adjusting diagnoses that patients did not actually have, were not considered or addressed during a...
Arizona News

Insys Founder Kapoor Sentenced to Prison, Seeks to Delay Term

Founder of opioid maker Insys Therapeutics John Kapoor, 76, was sentenced to 5 1/2 years in prison. The former billionaire, along with other executives, were convicted of organizing a national bribery scheme that ultimately was found to have fueled the opioid epidemic. Kapoor was given his 66 month sentence for the role he played...
National News

CMS Launches Projects to Fight-off Medicaid Fraud and Waste

To crack down on Medicaid fraud and waste, The Centers for Medicare & Medicaid Services (CMS) will conduct audits of state programs and private Medicaid managed care plans as part of an initiative announced Tuesday, June 26. CMS administrator Seema Verma attributed these plans to the agency's reformation of Medicaid for "a...
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