What's New

January 8, 2025

Updated: Corporate Integrity Agreements

January 3, 2025

Medicare Could Save Billions With Comparable Access for Enrollees if Critical Access Hospital Payments for Swing-Bed Services Were Similar to Those of the Fee-for-Service Prospective Payment System A-05-21-00018

January 2, 2025

Florida Did Not Comply With Federal Waiver and State Requirements at 18 of 20 Adult Day Care Facilities Reviewed A-04-23-000135

December 31, 2024

Advisory Opinion 24-13 (Favorable)

Enforcement Actions

January 7, 2025; U.S. Department of Justice

Marketers and Healthcare Providers in Texas, Virginia and South Carolina Agree to Pay Over $1.1M to Settle Laboratory Kickback Allegations

January 7, 2025; U.S. Attorney's Office, District of Connecticut

Connecticut Dentist Pays More than $600K to Settle False Claims Allegations

January 6, 2025; U.S. Department of Justice

Athira Pharma Inc. Agrees to Pay $4M to Settle False Claims Act Allegations Related to Scientific Research Misconduct

What's Trending

1. Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Triple-S Advantage, Inc., (Contract H5774) Submitted to CMS
2. Medicare Advantage Compliance Audit of Specific Diagnosis Codes Blue Care Network of Michigan (Contract H5883) Submitted to CMS
3. Medicare Advantage Compliance Audit of Specific Diagnosis Codes That UCare Minnesota (Contract H2459) Submitted to CMS
4. Indiana Made at Least $56 Million in Improper Fee-for-Service Medicaid Payments for Applied Behavior Analysis Provided to Children Diagnosed With Autism
5. Health Care Fraud and Abuse Control Program Report (Fiscal Year 2023)