January 10, 2020 03:37 PM UPDATED AN HOUR AGO HARRIS MEYER A California appellate court has rejected Dignity Health’s claim that L.A. Care Health Plan, a large Medicaid plan, owes it tens of millions of dollars in out-of-network bills for inpatient care following stabilization of medical emergencies. The Second District Court of Appeal on Thursday upheld a lower […]
Feds amassed $2.6 billion from 2019 healthcare fraud cases
January 09, 2020 SHELBY LIVINGSTON The U.S. Justice Department recovered more than $2.6 billion in 2019 from lawsuits involving healthcare fraud and false claims, federal data released Thursday show. The department’s recoveries from healthcare fraud cases have inched higher in recent years from roughly $2.5 billion in 2018 and $2.1 billion in 2017. The […]
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Appeals court strikes down individual mandate, stops short of scrapping entire ACA
December 18, 2019 SHELBY LIVINGSTON A federal appeals court ruled on Wednesday that the Affordable Care Act’s individual mandate is unconstitutional, but it stopped short of striking down the entire healthcare law. Two judges on the three-judge panel at the 5th U.S. Circuit Court of Appeals in New Orleans decided that the individual mandate is not constitutional […]
New CMS Final Rule to Allow Physician Assistants to Prescribe Medications to Hospice Patients
American Bar Association November 22, 2019 On November 15, CMS issued a Final Rule that will permit hospices to accept drug orders from a physician, a nurse practitioner (“NP”), or a physician assistant (“PA”). In 2018, CMS had issued a Final Rule amending the regulatory definition of “attending physician” for purposes of hospice care to include PAs. However, the […]
Sutter to pay $46 million over improper payment allegations
Photo Credit: (AP Photo/Rich Pedroncelli, File) (ASSOCIATED PRESS) November 18, 2019 03:34 PM HARRIS MEYER Sutter Health and a group of physicians agreed to pay the federal government $46.1 million to settle allegations that it violated the Stark law by billing Medicare for services by physicians with whom it had improper financial relationships, the Justice […]
Nutile Law recognized in “Best Law Firms” rankings by U.S. News & World Report and Best Lawyers®
U.S. News and Best Lawyers Release 2020 “Best Law Firms” Awards WASHINGTON – Nov. 1, 2019 – U.S. News & World Report and Best Lawyers®, for the 10th consecutive year, collaboratively announce the release of the “Best Law Firms” rankings. Firms included in the 2020 Edition of U.S. News – Best Lawyers “Best Law Firms” […]
OCR Imposes a $2.15 Million Civil Money Penalty against Jackson Health System for HIPAA Violations
October 23, 2019 The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services has imposed a civil money penalty of $2,154,000 against Jackson Health System (JHS) for violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security and Breach Notification Rules between 2013 and 2016. JHS is […]
HHS revamps Stark law rules to protect value-based payments, coordinated care
October 09, 2019 Michael Brady and Erica Teichert HHS on Wednesday unveiled its long-awaited proposal to change enforcement of anti-kickback laws, suggesting value-based payments and coordinated care should not fall under the Stark law’s purview. In two proposed rules from the CMS and HHS’ Office of Inspector General, the agencies said the kickback protections […]
Momentum builds to fix prior authorization
October 05, 2019 SHELBY LIVINGSTON Dr. Paul Harari, a radiation oncologist, likened it to torture. The interminable back and forth. The outdated fax machines. Wasting time on the phone to convince a health plan’s medical director that a cancer treatment the plan denied is the right way to go when he could be off taking […]