Compliance & Legal

NYC H+H goes after UnitedHealthcare for $11.5M in wrongful denials
May 23 | Susan Morse
CEO Mitchell Katz says it and other hospitals have been benefitting private insurance…
WV doctor faces 390 years in prison, $5 million fine for fraud
May 22 | Beth Jones Sanborn
Lone physician at family clinic charged with 19 counts of distribution of controlled…
Part D plan sponsors face compliance action on gag orders
May 18 | Susan Morse
CMS existing policy requires plan sponsors to ensure enrollees pay the lesser of the Part D negotiated price or…
Mercy Health settles for $14M over alleged improper physician payments
May 17 | Beth Jones Sanborn
The settlement resolves allegations that Mercy Health paid six employed physicians above and…
Memorial Hermann gets fined by DOJ
May 15 | Beth Jones Sanborn
Memorial Hermann allegedly billed for inpatient services for Medicare beneficiaries that could have been treated…
May 08 | Susan Morse
Some entities, such as ACOs, have to create work-arounds because they won't…
May 04 | Beth Jones Sanborn
Shephard Lee Spruill, CEO of Carolina Support Services, joins the growing contingent of hospital executives charged as criminals.
Court sides with UnitedHealthcare, Envision claims the win
May 04 | Susan Morse
Judge dismisses a contract dispute over billing practices that is now expected to head to…
HIPAA-required risk analysis is only way to compliance
May 04 | Jessica Davis
While gap analysis can find existing vulnerabilities in an organization's security, it's not an…
Florida CEO indicted for fraud
May 03 | Beth Jones Sanborn
Former chief executive of Calhoun-Liberty Hospital is charged with using money to pay various personal expenses like…