The 60-year-old Dallas-area doctor and six co-defendants defrauded Medicare and Medicaid out of almost $375 million by certifying 11,000 Medicare beneficiaries through home health providers. Their numbers would have made the doctor's Medicare practice the busiest in the country.
Drugmakers Baxter International and Claris Injectables agreed to divest two pharmaceutical products to settle Federal Trade Commission antitrust concerns over Baxter's proposed $625 million acquisition of Claris' injectable drugs business.
The government doesn't know how much of the $24 billion for premium tax credits was improperly paid and the Government Accountability Office says HHS won't have an estimate until 2022.
The Federal Trade Commission approved the appointment of Quantic Regulatory Services as a monitor in its case alleging that Endo Pharmaceuticals violated antitrust laws by using pay-for-delay settlements to block consumers' access to lower-cost generic versions of Opana ER and Lidoderm.
The federal government has been cracking down on certain hospice providers, including Philadelphia-based Home Care Hospice, who game the system to capture higher reimbursements.
AnMed Health has agreed to pay the largest-ever settlement in a case brought under the federal law requiring hospitals to stabilize and treat patients in emergency situations.
Owners of the Pacific Alliance Medical Center in Los Angeles agreed to pay $42 million to settle allegations that they violated the False Claims Act by providing kickbacks to referring physicians.
Genesis Healthcare, one of the nation's largest investor-owned skilled nursing, senior living and rehabilitation therapy providers, will settle six lawsuits alleging that its acquired companies billed Medicare for unnecessary treatment and delivered grossly substandard nursing care.
Bloomfield, Conn.-based Cigna may immediately resume marketing its Medicare Advantage plans and enrolling members. Insurance industry analysts noted that the lifted sanctions pave the way for Cigna to pursue an acquisition in the lucrative Medicare Advantage segment.
The CMS allegedly made more than $729 million in incentive payments to providers who shouldn't have received them. But that kind of waste is almost run of the mill.
The CMS will not expand a pilot that let consumers see how many providers were offered on plans purchased on HealthCare.gov. The pilot will remain targeted to Maine, Ohio, Tennessee and Texas.
The FDA's request marks one of the first times the agency has tried to get an opioid pain medication off the market because of the public health consequences of abuse.