Novartis Pharmaceuticals Corp. paid kickbacks to a specialty pharmacy in exchange for recommending refills of a blood transfusion drug it produces, according to an amended complaint filed Wednesday in a civil case brought by state and federal prosecutors in New York....
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Government
NC encourages health care navigators at county health sites
North Carolina health officials have cleared local social service agencies to help the public shop for subsidized insurance under the Affordable Care Act. The local health departments are bracing for an influx of people seeking help and advice on Oct. 1, the beginning...
Beaver County woman accused of duping Medicare for $200K
A Beaver County woman forged signatures of doctors and other medical providers to bilk Medicare out of $200,000 in reimbursements, federal prosecutors said. A federal grand jury on Tuesday indicted Mary Monica Wilson-Lefler, 62, of Economy on a charge of health care...
Affordable Care Act providing potential targets for Scammers
Enrollment begins for a national health insurance program in two weeks, and Wisconsin officials are already bracing for what could be an unprecedented wave of fraud attempts. The National Consumers League said criminals across the nation have begun using confusion...
Pennsylvania proposes alternative to expansion of Medicaid
Pennsylvania Governor Tom Corbett unveiled a plan on Monday to use federal subsidies targeted for an expansion of Medicaid to be used instead to help low-income residents of the state buy private health insurance. Corbett, a Republican who has been opposed to...
CMS issues guidance on survey timing for facilities that change ownership
Surveyors should prevent providers from being able to game the Medicare system through well-timed facility sales and purchases, the Centers for Medicare & Medicaid Services instructed in a recent memorandum. When a new owner acquires an existing facility that has...
GAO Releases Report on CMS Auditors
The Government Accountability Office (GAO) released a report titled "Increasing Consistency of Contractor Requirements May Improve Administrative Efficiency." GAO undertook the study at Congress' request because questions have been raised recently about the efficiency...
With state out of picture, feds push to create Alaska health exchange
With the state forgoing any role in a health insurance marketplace, federal officials and Alaska nonprofits are scrambling to fill the void by Oct. 1. That's the first day of open enrollment under the Affordable Care Act, and the date by which each state is supposed...
Organized medicine groups line up against proposed Stark law changes
Citing the need for patient access to critical services and other concerns, the American Medical Association and 31 other organized medicine groups and associations representing practice administrators stated their strong opposition to federal legislation that would...
OIG to Investigate Bidding Program
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has announced plans to investigate the controversial Medicare bidding program to "determine whether CMS selected DMEPOS suppliers and computed the single payment amounts in accordance...
Louisiana Home Health Company Operators Sentenced in $17.1 Million Fraud Scheme
The owner of South Louisiana Home Health Care Inc. and the director of nursing for the Louisiana home health agency were sentenced today for their roles in a Medicare fraud scheme involving the payment of kickbacks and the falsification of documents. Acting Assistant...
Upcoming CMS Education Initiatives
The next year is one filled with changes for Medicare providers. Understanding those changes now can help make implementation a easier experience. For information on earning continuing education credit for attending CMS provider education calls, please see the CMS CE...