April OIG Work Plan Focuses on Oversight of State, Federal Funding

Each month, the U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) releases updates to its Work Plan, which outline the various projects it intends to focus on in the coming months. The April Work Plan addressed a number of items that should be of interest to a variety of […]

Court Rules Against United’s Offsetting Policy

UnitedHealth Group’s policy of withholding payments to out-of-network physicians and doctors in order to recover previous overpayments – a practice known as cross-plan offsetting – is not permissible and may even violate The Employee Retirement Income Security Act (ERISA). That was the long-awaiting ruling from the Eighth Circuit Court of Appeals issued last week. The […]

What happens if you become the target of a healthcare fraud investigation?

No healthcare provider wants to become the target of a healthcare fraud investigation. But, as we have seen, it happens more often than we would like to think. Not only does a healthcare fraud investigation come with the potential for criminal penalties, but the state also can impose harsh consequences resulting in the loss of […]

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