This article explains the mutual interest of providers and payors in facillitating provider access to aggregated claims data and then offers guidance for clearing the legal and practical hurdles in obtaining such data from Medicaid. Sample data requests are included. (click here to read more...)
Acting as the eyes and ears for the federal government could prove to be a financial windfall for those who take advantage of the federal False Claims Act. The act, whose history dates to the Civil War, allows private citizens or companies to file lawsuits on behalf of the federal government against those believed to have defrauded the government. As a reward for bringing the action, these private citizens, or whistleblowers, share in the settlements or court verdicts, which can reach hundreds of millions of dollars. (click here to read more...)
Little Rock - Christopher R. Thyer, United States Attorney for the Easter District of Arkansas; Valery Parlave, Special Agent in Charge of the Little Rock Field Office of the Federal Bureau of Investigation (FBI); and Mike Fields, Special Agent in Charge of Health and Human Services Office of the Inspector General (HHS_OIG) announced today that the United States has settled a federal qui tam lawsuit filed under the False Claims Act against a Little Rock hospice and its owners and operators for $2,700,000.00. The lawsuit, which was filed by Arkansas Hospice, Inc. as relator, alleges that Hospice Home Care, Inc. billed Medicare for general inpatient (acute) care in situations where only routine care was provided. The Government's investigation revealed (click here to read more...)
Formerly a PowerPoint Presentation, now converted to PDF, that is centered around what to expect in relation to the Health Care Reform Act
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