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Tuesday, August 17, 2021 August 17, 2021. When going to the doctor, one’s diagnosis should not drastically change after a visit, nor should one expect to see a diagnosis on their health insurance claim for a condition not discussed at the visit. Kaiser Permanente consortium members (“Kaiser”) allegedly encouraged physicians to falsify diagnosis codes for Medicare Advantage Plan patients to garner higher reimbursements.
Wednesday, May 22, 2019 On May 6, 2019, a federal district court held that the Department of Health and Human Services’ (HHS) 2018 and 2019 rate reductions for 340B Program participants, including safety net hospitals and other providers, were unlawful. Although the court found that the 340B rate cuts in both 2018 and 2019 were unlawful, it did not vacate the rules because doing so would wreak havoc on Medicare’s administration.
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