There’s a new article in Health Affairs about “site neutral” payments that could change everything for hospital-based outpatient departments – and by that, I mean, possibly end them. However, I have been wrong about this threat for more than a decade – which means...
Preview your performance before it is public The “Doctors and Clinicians Preview Period” is officially open as of Tuesday, May 27, 2025. Clinicians who reported data as part of the Quality Payment Program (QPP) in 2023 can preview their 2023 performance information...
Last week, the Head of the Justice Department’s Criminal Division, Matthew R. Galeotti, delivered remarks at an Anti-Money Laundering and Financial Crimes Conference, announcing that the DOJ’s Criminal Division was “turning a new page on white-collar and corporate...
According to the US Department of Justice (DOJ) Civil Division, many of the Fraud Section’s cases are suits filed under the False Claims Act (FCA), 31 U.S.C. §§ 3729 – 3733. The FCA is a federal statute originally enacted in 1863 in response to defense contractor...
Stateline reports health insurance companies are facing “scrutiny for allegedly using artificial intelligence bots and algorithms to swiftly deny patients routine or lifesaving care” without a human reviewing the claims. Lawmakers in in more than a dozen states are...
