HEALTH SYSTEMS CONTINUE TO ACQUIRE INSURERS

The wall between health care providers and health insurers continues to erode, as Ascension Health’s CEO acknowledges Ascension is in talks to acquire WellCare Health Plans.  Ascension is the nation’s largest nonprofit health system, with 101 hospitals.  WellCare is a Medicare and Medicaid managed care …

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KENTUCKY HOSPITAL PAYS $41 MILLION TO SETTLE FRAUD CHARGES

Yesterday Kentucky’s largest hospital, King’s Daughters Medical Center, in Ashland, announced its agreement to pay $40.9 million to settle charges that it committed Medicare and Medicaid fraud by billing for coronary procedures that were unnecessary and by falsifying medical records related to those …

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HALIFAX HEALTH GETS IN MORE HOT WATER

You probably didn’t think Florida’s Halifax Health could make its situation any worse.  After all, only two months ago Halifax agreed to pay $85 million to settle just the first half of a Medicare fraud case.  That still leaves the second half of the case, now set for trial in July.  With penalties and …

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FEDERAL COURT INVALIDATES 340B ORPHAN DRUG REGULATION

Last Friday a federal district court invalidated a regulation that had authorized the 340B discount for critical access hospitals, sole community hospitals, rural referral centers and free-standing cancer hospitals when they purchase orphan drugs for off-label purposes. Two concepts are necessary for …

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CMS JOINS IN BASHING THE TWO-MIDNIGHT RULE

It’s unanimous.  Everybody hates the two-midnight rule—even CMS. Hospitals hate it.  Doctors hate it.  Congress hates it so much it required CMS to delay audits of compliance until next year.  Then yesterday CMS Deputy Administrator Sean Cavanaugh, testifying before a House Committee panel, acknowledged …

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POSTINGS THAT DEFAME A SURGEON ARE NOT ACTIONABLE

A federal court in Kentucky ruled last week that a surgeon does not have a cause of action against a disgruntled patient who posted defamatory material about the surgeon on-line. Catherine went to Dr. Loftus for some body work: breast implants, breast lift, arm lift (both arms) and a tummy tuck.  She was …

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