Arizona Attorney General Kris Mayes has vowed to improve nursing home quality and transparency throughout the state. Her biggest target is the Ensign Group, one of the largest publicly traded nursing home chains in the country, which owns nearly a third of Arizona nursing home beds.
A study on the Ensign Group found that revenues for...Arizona News
Arizona is getting assistance from the federal government in its ongoing effort to clean up fraudulent activity in the tribal health sector. The U.S. Attorney's Office for the District of Arizona has charged the CEO of Apache Behavioral Health Services (ABHS) and a co-conspirator on embezzlement, wire fraud and conspiracy charges.
The...
Last week, the Southern District Court of Ohio heard the first oral arguments from the U.S. Chamber of Commerce (CoC, the Chamber) and the U.S. Department of Justice (DOJ). The Chamber requested an injunction of the Medicare negotiation program before October 1, which is the deadline for companies to sign an agreement to participate in...
In recent weeks, a shortage of powder infant formula caused by pandemic supply chain issues was exacerbated by a recall at a major U.S. production plant. The shortage has sent families and pediatricians across the country into crisis, even as the Food and Drug Administration (FDA) and pharmaceutical manufacturer Abbott Nutrition promise...National News
The U.S. Justice Department officially announced a lawsuit to stop UnitedHealth Group’s acquisition of Change Healthcare this week, while companies ranging in size from startups like Sesame to mega-corporations such as Tenet and Cigna continue to seek new ways to utilize software and technology in healthcare – either for profit or...National News
Throughout 2021, The Department of Justice (DOJ) cracked down on healthcare fraud, with special emphasis on fraud related to Medicare and Medicaid. As the population ages, Medicare Advantage plans have increased in popularity, leading to a direct increase in Medicare related fraud. The Department of Justice’s focus on healthcare fraud...
This month has been busy for insurance fraud claims both big and huge, from the U.S. Department of Justice (DOJ) intervening on a False Claims Act suit to the State of Pennsylvania's Medicaid program finding fault with Aetna to former players in the National Football League (NFL) defrauding the NFL Player's association retirement health...
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...National News
Repealing and replacing the Affordable Care Act (ACA) has been central to the GOP crusade on healthcare since President Trump's election in 2016. He promised to overhaul the legislation and completely reform America's healthcare system right away, but now that SCOTUS could rule and declare it unconstitutional, there seems to be no...National News
The U.S. Department of Justice (DOJ) cracked down on 35 individuals found to be tampering with genetic testing reimbursements in a fraudulent Medicare billing scheme totaling $2.1 billion. The defendants were linked to various telemedicine and telemarketing companies as well as cancer genetic testing labs for their participation in the...News
A federal judge sentenced a Miami mogul to 20 years in prison and $207 million in restitutions for committing what prosecutors are calling the largest healthcare fraud scheme in America’s history.The culprit in this case is 50-year-old Philip Esmores, the mastermind behind a network of nursing homes and healthcare facilities that...
