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Federal officials announced this week that one of the nation’s largest health insurers has agreed to pay $117.7 million to resolve fraud allegations. The False Claims Act (FCA) case involved Aetna, Inc., which the U.S. Department of Justice (DOJ) said failed to withdraw inaccurate and
It is a bummer when you get hoisted on the petard of intellectual inconsistency. Whether it is different medical professionals with different approaches to a
The Centers for Medicare & Medicaid Services’ (CMS’s) $50 billion Rural Health Transformation Program was designed by the Trump Administration to reshape healthcare delivery in
At times, it can seem as though the chips are stacked against hospitals. There are a multitude of organizations collecting hospital claim data and monetizing
In a recent article, I described a documentation environment governed by two distinct and often competing controlling systems. The first is the regulatory framework established
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