Compliance & Legal

Oct 14 | Jeff Lagasse

Genetic testing company accused of Medicare fraud settles for $42.6 million

UTC Laboratories was charged with billing Medicaid for unnecessary pharmacogenetic testing.

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Sep 30 | Jeff Lagasse

DOJ breaks up alleged genetic testing fraud scheme estimated at $2.1 billion

The defendants ordered unnecessary tests that were reimbursed by Medicare, with laboratories sharing the profit,…

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Sep 16 | Jeff Lagasse

Kaiser Permanente workers planning strike that could be largest in more than two decades

At issue is what unions call unfair labor practices that have shifted the focus to enriching Kaiser…

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Sep 16 | Susan Morse

OxyContin maker Purdue Pharma files for Chapter 11 bankruptcy, settles lawsuits

Sackler family would exit Purdue, pay $3 billion; the company would give more than $10 billion towards opioid…

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Sep 10 | Jeff Lagasse

CEO of telemedicine company pleads guilty to Medicare fraud in $424 million scheme

CEO Lester Stockett was among 24 telemedicine executives charged in schemes billing Medicare $1.7 billion,…

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Aug 28 | Jeff Lagasse

One-third of pre-approved prescription drugs have not completed the FDA approval process

From 1992 to 2008, 36% of post-market studies had not been completed, and many took five years to…

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Aug 27 | Jeff Lagasse

California legislature passes bill requiring Kaiser Permanente to follow financial disclosure laws

The bill would require Kaiser Permanente to provide more data about the revenue and profits…

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Aug 23 | Susan Morse

Centene, Aetna protest losing Louisiana MCO contracts worth billions

The Centene subsidiary, Aetna and three other MCOs were paid $7.6 billion by Medicaid to cover more than 1.7 million…

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Aug 15 | Jeff Lagasse

Majority of providers fall short of compliance with HIPAA access requirements

The primary reason for noncompliance was that most providers don't send records electronically even when so…

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Aug 09 | Susan Morse

Allscripts pays $145 million to settle Practice Fusion civil and criminal investigation

Despite reporting strong second quarter bookings increases of 31% over the previous year, Allscripts…

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Featured Resources

Debunk the Myth: Outsourcing Doesn't Mean Losing Control With shifts in payer mixes and reimbursement structure, the margin of reimbursement has been shrinking steadily over the last five years. How do revenue cycle leaders navigate payment reform while maintaining stable business office operations?

Care Collaboration Success for Improved Outcomes The nature of our healthcare ecosystem has been one of siloed care. Rarely do payers, providers and local resources come together with the patient's well-being prioritized as a unifying mission. Read how these organizations are getting it right.

Beyond Dollars and Cents: A Closer Look At Value Beyond the expected improvement in specific metrics, many organizations that outsource RCM with a trusted and certified partner are seeing several ancillary benefits of such agreements.

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Once-failing hospitals say accountability, transparency key to surviving fallout from failing patient safety grades When Leapfrog released their Spring 2016 patient safety grades recently, 15 hospitals got slapped with a very public 'F' grade casting a spotlight on them that no institution wants. ...

Healthcare mergers and acquisitions in 2016: Running list While 2015 was a record-breaking year in healthcare mergers and acquisitions, 2016 saw more change as organizations across the industry adjust and adapt to the evolving financial landscape.

Analyze this: Health systems, health plans get to the core of big data Pamela Peele knows that people who subscribe to cooking magazines have a much higher risk of going to the emergency room. But how she knows that is a whole other story.

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Gaining Actionable Insight into Financial Systems and Areas Impacting the Revenue Cycle Hospital systems across the country are looking to streamline their billing and collection processes to become more efficient and better compete in their markets. The challenge many face is how to turn the data ...

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