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publication date

Revenue Cycle
Whistleblower Costs Health System $12M for Fraudulent Billing
Amanda Norris | May 22, 2023
A large health system allegedly issued claims for urgent care services billed at a higher level of service than received...
Human Resources
Unions Ask DOJ to Investigate UPMC's 'Anticompetitive Tsunami'
John Commins | May 18, 2023
SEIU, SOC accuse PA's largest health system of widespread abuses of market power.
Payer
Covenant Healthcare Paid $69M to Settle FCA Allegations
John Commins | March 30, 2023
Two physicians allegedly involved in the scheme to defraud Medicare, Medicare, TRICARE and other government payers will also pay a...
Strategy
AHA, AHIP, AMA, PhRMA Alliance Urges SCOTUS to Uphold False Claims Ruling
John Commins | March 29, 2023
Billions of dollars at stake as high court takes up central tenets of the FCA.
Marketing
UPMC Will Pay $8.5M to Settle False Claims Allegations; Separate 'Sordid Vendetta' Defamation Suit Continues
John Commins | February 27, 2023
The settlement is the latest development in an ongoing, bitter feud between former colleagues who've traded accusations of drug abuse...
Payer
Centene to Pay $215M to Resolve Medi-Cal Drug Overcharges
John Commins | February 09, 2023
Centene admits no wrongdoing in the settlement, but will pay back twice the value of its inflated price reporting.
Strategy
DOJ Strikes 'Outdated' Policies That Tamp Healthcare Competition
John Commins | February 07, 2023
Justice officials note that the withdrawn guidance hasn't kept pace with the rapidly changing healthcare landscape.
Payer
Jury Finds ENT Doc Guilty of Reusing Disposable Sinuplasty Devices, Related Fraud Charges
John Commins | January 30, 2023
Anita Louise Jackson, MD, faces up to 20 years in prison when she is sentenced later this year.
Pharma
Mich. Woman Convicted in $65M Pharma 'Coupon' Scam
John Commins | January 18, 2023
Suzan Berro submitted fake reimbursement claims to several drugmakers' co-pay assistance programs.
Payer
3 Providers Will Pay $22.5M to Settle Medi-Cal False Claims Allegations
John Commins | December 08, 2022
Prosecutors say the settlements resolve allegations of an 'organized scheme to wrongfully retain federal funds.'
Revenue Cycle
Former physician sentenced for second healthcare fraud conviction
Office of Inspector General | December 02, 2022
Damian Williams, the United States Attorney for the Southern District of New York, announced that SPYROS PANOS was sentenced to...
Strategy
Sutter Health Will Pay $13M to Settle False Claims Allegations
John Commins | October 26, 2022
DOJ says Sutter billed government payers for urine tests performed by third-party labs.
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