A federal appeals court recently ruled against UnitedHealthcare, reversing a 2018 decision involving Medicare Advantage overpayments and sending the case back to the lower court with instructions to rule in favor of the Centers for Medicare & Medicaid Services (CMS). The lower court’s ruling in UnitedHealthcare Insurance Co. v. Azar, No. 16-157 (D.D.C.), vacated Medicare’s…

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Earlier this month, the Pharmaceutical Research and Manufacturers of America (PhRMA), announced it had made changes to its Code on Interactions with Healthcare Professionals. The “PhRMA Code” updates principles applicable to company-sponsored speaker programs. Although voluntary, the standards outlined are considered best practices and generally are followed by drug and medical device companies. In fact,…

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The federal government recouped nearly $3.1 billion last year following investigations into healthcare fraud, according to a new report released by the U.S. Department of Health and Human Services and the Department of Justice. The annual report noted that DOJ opened 1,148 new criminal healthcare fraud investigations in 2020, filing criminal charges in 412 cases…

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