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21 Oct 2013, 8:43 am by Rebecca Shafer, J.D.
This eliminates many of the billing issues that can arise with the use of medical management. [read post]
13 Apr 2011, 4:03 pm by Rebecca Shafer, J.D.
 They are also utilized by health insurance companies and CMS (Centers for Medicare and Medicaid Services) for the pricing of medical billing. [read post]
9 Mar 2009, 9:53 pm
On January 8, 2009, the Supreme Court of California issued a unanimous decision in Prospect Medical Group Inc. v. [read post]
4 Feb 2009, 8:00 am
January 13, 2009 UnitedHealth Group Inc. settled with the New York State Attorney General Andrew Cuomo after a probe of the independence of its database used to set reimbursement rates for patients' medical bills. [read post]
28 Jul 2023, 2:00 am
COMPANY AGREED TO PAY OVER $300K TO SETTLE CIVIL CHARGESVitalAxis Inc., a Maryland-based company that provides billing services to diagnostic labs, agreed to resolve False Claims Act civil charges for $300,479.58, according to a recent press release issued by the United States Justice Department.Apparently, the company subjected senior citizens to tests -- known as “respiratory pathogen panels” -- which had not been ordered by a physician and, in any event,… [read post]
24 Jul 2009, 12:39 am
A Petition for Certiorari has been filed to the US Supreme Court in a RICO claim involving a medical provider who claims an insurance company committed fraud in processing the provider's bills for services. [read post]
13 Dec 2010, 12:41 am by John Day
 The court disagreed, saying   We recognize that there may be a disparity between the cost of medical services that are billed to a consumer and the amounts that are actually paid by insurance companies. [read post]
29 Jan 2016, 5:30 am by Kori Shafer-Stack
An attorney and a medical service provider were summoned to appear in federal court. [read post]
15 Oct 2014, 9:21 pm by Ben Vernia
Attorney’s press release: ATLANTA – The United States Attorney’s Office announced that it has reached a settlement with Medical Business Service, Inc. [read post]
1 Jul 2019, 11:48 am by opedit
Services Performed When you check the services performed section of your medical bill you may have to ask for help from your healthcare provider’s office to see what the codes and charges mean. [read post]
5 Aug 2011, 3:00 am by Tom Huddleston Jr.
Stillwell led the Ropes & Gray team advising private equity firm the Blackstone Group on its acquisition of medical-billing services company Emdeon Inc. [read post]
7 Aug 2014, 2:27 pm by Fraud Fighters
(CHS) has agreed to pay $98.15 million to settle allegations that it violated the False Claims Act when it knowingly overcharged the Government by billing government health care programs for inpatient services that should have been billed as outpatient or observation services. [read post]
26 Apr 2007, 9:11 pm
The cases involve allegations of upcoding -- improperly using a diagnosis code that is not supported by the medical record, for the purpose of obtaining greater reimbursement--and billing for medically unnecessary services. [read post]
2 Jul 2012, 3:36 pm by fraudfighters
Earlier this year, the Department of Justice announced an $18.5 million settlement with LifeWatch Services Inc. that resolved allegations from two whistleblower lawsuits about the company’s billing for ambulatory cardiac telemetry (ACT) services. [read post]
18 Dec 2015, 10:06 am by Edward Smith
Thanks to the 2009 California Supreme Court decision of Prospect Medical Group, Inc. v. [read post]
22 Aug 2014, 6:30 am by Michael B. Stack
The medical bill charges will either be compared to the state fee bill schedule or with what are reasonable and customary charges for the medical services that have been provided. [read post]
1 Jan 2020, 9:00 am by Staff
Types of medically-related false claims acts in the healthcare sector include: False billing Billing for services never rendered Billing for services that weren’t necessary Improper coding for services Several cases show that the hospitals, doctors, and other health providers will be prosecuted if they provide medical services that are deemed medically unnecessary or if fraudulent claims are submitted. [read post]