Enforcement & Compliance

Texas doctor gets 35 years in prison for $375M medical fraud

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.

FTC-approved monitor will keep an eye on Endo's pay-for-delay case

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.

CMS lifts Medicare Advantage sanctions on Cigna

CMS lifts Medicare Advantage sanctions on Cigna

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.


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