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HHS agency signals drug rebate program redux with request for information
The RFI is the Trump administration’s next move to get its drug pricing rebate program back on track after hospital groups blocked it last year.
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FCA Healthcare roundup: Three cases of Medicare and Medicaid fraud in IL, MN, NY
Our in-brief, biweekly roundup of notable US Department of Justice False Claims Act cases related to healthcare fraud.
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Former NY bank employee pleads guilty to laundering medical device fraud proceeds
The DOJ said a former Bank of America relationship manager helped launder more than $8m on behalf of an international criminal organization.
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Former Seahawks tight end convicted in $200m healthcare fraud scheme
Joel Rufus French pressured elderly Americans to provide their personal and health insurance information and accept unnecessary orthotic braces.
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DOJ secures record-breaking $6.8 billion in False Claims Act settlements, judgments for FY 2025
The healthcare fraud category took the lion’s share with a staggering $5.7 billion in recovered funds from FCA matters.
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CMS presents shake-up for Medicare Advantage star ratings
The agency suggested dropping 12 quality measures of health plan performance and refocusing on aspects like patient experience.
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Three faces of healthcare fraud: the billing practices that cost federal programs millions
Recent DOJ actions, including two Michigan pharmacy schemes and a nationwide wound care provider, show how different types of misconduct can thrive within the same reimbursement system.
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CMS quietly rolls out new round of Medicare-negotiated drug prices
The second-cycle negotiated-price drugs include medicines to treat cancer, asthma, and metabolic conditions.