Tag Archive | "settlement"
United Settles with Physicians, Subscribers for $350M
United agrees to record-breaking settlement covering flawed out-of-network claims for last 15 years. An important case that could change how health plans use databases to determine usual, customary and reasonable (UCR) rates has been settled, and more litigation is in…
Continue reading...UBS Settles Healthsouth Case with Michigan for $117M
Monday, May 17, 2010
Money will go to State Pension Fund to benefit future retirees. Financial services firm UBS and three of its former employees reached a $117 million settlement with Office of the Attorney General (OAG) in Michigan. The amount settles UBS’s financial…
Continue reading...Infusion Drug Coding Error Ends in Settlement for Overbilling
Thursday, March 4, 2010
CEO says human error played a role in the alleged violation. What may have been only one coder’s mistake has ended with Connecticut-based Johnson Memorial Hospital paying the federal government $191,193 to settle allegations of fraud, the US…
Continue reading...15-Bed Hospital, Physician Settle Medical Necessity Qui Tam Case
Monday, January 11, 2010
Faulty physician documentation was an Achilles heel in the case. Three patients who stayed multiple days in Wheaton Community Hospital in Wheaton, MN as inpatients — yet received only oral pain meds and PT during their hospital stays — is an…
Continue reading...DOJ: 2 SNF Chains & Their Principles Named In Omnicare, Risperdal Complaint
Monday, November 9, 2009
At issue: The antipsychotic drug Risperdal & fair market value. Last week, the Department of Justice announced that nation’s largest nursing home pharmacy, Omnicare Inc., will pay $98 million to settle False Claims Act allegations. IVAX Pharmaceuticals (now a subsidiary of…
Continue reading...How One Hospital’s Physician Gifts Ran Afoul of Stark
Monday, October 12, 2009
One lesson learned: A central tracking system can flag multiple gifts. Your hospital can learn a lot from the mistakes of others, especially when it comes to the slippery Stark rules. On June 26, 2009, the…
Continue reading...Does ‘The Consultant Told Me to Do It’ Hold Up in Court?
Tuesday, June 2, 2009
Snake charming? No, thank you. Texas hospital pays nearly $10 million for inflated outlier charges If your health system has increased charges to potentially increase outlier reimbursement, you’d better have the documentation…
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Monday, May 24, 2010
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