(Reuters)—The president of Hollywood Presbyterian Medical Center said on Wednesday that his hospital paid hackers a ransom of $17,000 in bitcoins to regain control of their computer systems after a cyber attack. Allen Stefanek said in a statement that paying the ransom was the “quickest and most efficient way” of regaining access to the affected…
Pfizer Unit to Pay $784.6 Million in Medicaid Rebate Settlement
(Reuters)—Pfizer Inc. said its Wyeth unit has agreed to pay $784.6 million to settle cases related to the calculation of Medicaid rebates for a gastric drug between 2001 and 2006. The claims alleged that Wyeth’s calculation of rebates for its proton pump inhibitor Protonix (pantoprazole) violated the Federal Civil False Claims Act and other laws…
Hospital Acquisitions of Physician Practices Likely to Decrease
On Nov. 2, 2015, President Barack Obama signed the Bipartisan Budget Act of 2015 (the Act) into law. This critical piece of legislation raises the federal debt ceiling and provides the framework for the federal budget through 2017. Of particular importance, the Act significantly changes the way Medicare will reimburse hospitals for outpatient services furnished…
U.S. Appeals Court: Hospitals Can Be ‘Urban’ & ‘Rural’ at Same Time
NEW YORK (Reuters)—The federal appeals court in New York struck down a U.S. regulation that made it harder for hospitals to provide better medical care at lower cost by claiming they were “rural” for some purposes and “urban” for others. Thursday’s decision by the Second U.S. Circuit Court of Appeals is a victory for hospitals…
California Doctor Gets 30 Years to Life in Landmark Overdose Case
LOS ANGELES (Reuters)—A Southern California doctor was sentenced to 30 years to life in prison on Friday for over-prescribing drugs that caused the fatal overdose of three patients in a murder case capped by the first conviction of its kind in the U.S. The case against Dr. Hsiu Ying “Lisa” Tseng, 46, comes amid what…
U.S. Government Suspends Enrollment in Cigna Medicare Advantage, Drug Plans
(Reuters)—The U.S. government has suspended new enrollment in Cigna Corp’s Medicare Advantage health plans for seniors and standalone Medicare prescription drug plans, citing noncompliance in its appeals and grievances procedures. The government said Cigna had deficiencies in its appeals and grievances processes in both Medicare Advantage and the Medicare prescription drug program, according to a…
How to Avoid Legal Pitfalls
In busy rheumatology practices, mountains of paperwork for insurance companies and federal healthcare programs make it hard to keep track of what’s legal. Missing documentation is the most common way to spark an investigation. Here are a few considerations to help you avoid legal pitfalls…
U.S. Top Court Rejects New Challenge to Obamacare
WASHINGTON (Reuters)—The U.S. Supreme Court, which delivered major rulings in 2012 and 2015 preserving President Barack Obama’s signature healthcare law, on Tuesday declined to take up a new, long-shot challenge to Obamacare brought by an Iowa artist. The court turned away an appeal by Matt Sissel, who had asserted that the 2010 Affordable Care Act…
New York Orders UnitedHealth to Pay $100,000 to Settle Antitrust Probe
WASHINGTON (Reuters)—The New York Attorney General has ordered UnitedHealth Group to pay a $100,000 fine after an investigation found the insurance provider engaged in anti-competitive practices involving elder and long-term care products, according to a person familiar with the matter. The settlement, which was signed late Wednesday, centers on efforts by UnitedHealth to force nursing…
Five Charged in $600 million California Healthcare Fraud Scheme
LOS ANGELES (Reuters)—The former chief financial officer of a California hospital and four other people have been charged in a series of health care kickback schemes that generated nearly $600 million in fraudulent billings for spinal surgeries, prosecutors said on Tuesday. All five defendants have agreed to cooperate in a wide-ranging federal investigation into the…
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