Medicare Compliance & Reimbursement
PRIVATE LABELING LEADS TO CRIMINAL FINES
The feds mean business when it comes to drug pricing improprieties. Case in point: A federal judge May 8 sentenced Bayer Corp. after the company pleaded guilty to a felony charge connected with a private labeling scheme. Judge Richard Stearns ordered the company to pay a $5.6 million criminal fine. The fine is just the tip of the iceberg, however. The company also will pay about $250 million to settle related civil claims. The Department of Justice maintains that Bayer engaged in "private labeling" for Kaiser Permanente. Bayer gave Kaiser a low price and affixed slightly different labels to the products it sold the HMO - labels that allowed the drugmakers to avoid reporting the discounted Kaiser prices to the federal government. That enabled Bayer to evade paying some of its rebates to Medicaid, which are designed to ensure that the government receives the lowest drug price offered to other purchasers. Lesson Learned: The Bayer criminal case shows that the DOJ means business in its hunt for those who violate Medicaid rebate rules.
Medicare Compliance & Reimbursement
- Budget:
HELP FOR STATES, RURAL AREAS IN SENATE BILL
The tax bill passed by the Senate May 15 includes $20 billion in fiscal relief [...] - Hospitals:
INPATIENT RULE LOWERS HIGH-TECH THRESHOLD
The Centers for Medicare and Medicaid Services says hospitals would get a 3.5-percent pay raise [...] - Medicare:
GAO: DEATH TO LOCAL COVERAGE PROCESS
The Centers for Medicare and Medicaid Services should strip Medicare contractors of their authority to [...] - Rehab:
75-PERCENT RULE ENFORCEMENT LOOMS FOR IRFs
Rehab hospitals are in line for a 3.3-percent increase in their Medicare payments - but [...] - Medicaid:
MEDICAID REVISIONS STILL UP IN AIR ON HILL, AMONG GOVERNORS
The National Governors Association task force on Medicaid is a long way from consensus on [...] - Pharmaceuticals:
PRIVATE LABELING LEADS TO CRIMINAL FINES
The feds mean business when it comes to drug pricing improprieties. Case in point: A [...] - Hospitals:
19 DRGs ON PER-DIEM CHOPPING BLOCK
Hospitals have long grumbled over the Centers for Medicare & Medicaid Services' post-acute transfer policy. [...] - Managed Care:
2004 M+C RATES LOW-BALL PLANS
Health plans aren't happy with the Centers for Medicare & Medicaid Services' 2004 Medicare+Choice payment [...] - Overpayments:
CONTRACTORS TOUT PAYMENT SAFEGUARD HAULS
Medicare contractors are boasting once again about the financial fallout from their medical review, fraud-fighting [...] - Kickbacks:
DEDUCTIBLE DEALS LEGAL BETWEEN HOSPITALS, MEDIGAP PLANS
Medigap insurers may be able to work deals with hospitals for cut rates on inpatient [...] - Help With HIPAA:
4 STEPS FOR HANDLING PRIVACY COMPLAINTS WITHOUT GETTING BURNED
Even if you have a top-notch privacy compliance program in place, you're bound to be [...] - HIPAA:
PART A PROVIDERS OPTIMISTIC ON HIPAA TRANSACTION STANDARDS
Medicare Part A providers are generally confident that they'll be ready for the Oct. 16 [...] - PROGRAM MEMO ROUNDUP
Skilled nursing facilities puzzled over Medicare policy for bill types 22x and 23x can take [...] - REGISTER WATCH
Skilled nursing facilities will see a 2.9 percent increase in their Medicare payments next year [...] - BILL WATCH
The following House bill was introduced: H.R. 2070. A bill to amend title XVIII of [...]
