Hospice Insights Podcast - What's Good and Bad in Hospice Right Now: A Conversation with Greg Grabowski, Partner at Hospice Advisors
Strategic Restructuring for the Future - Think Before You Sign: Five Key Insights for VBID and Managed Care Contracts
Part Two: The MFN Drug Pricing Rule and the Rebate Rule: Where Do We Go From Here?
Part One: Two new Medicare Drug Pricing Rules in One Day: What are the MFN and the Rebate Drug Pricing Rules?
Health Care Enforcement: The Impact on Private Equity Investments
Why Health Care Providers Need A Managed Care Strategy
CalAIM is an initiative of the California Department of Health Care Services (the Department) to improve the quality of life and health outcomes of Medi-Cal members by implementing delivery system, program, and payment...more
California is among a handful of states that seeks to regulate the use of artificial intelligence (“AI”) in connection with utilization review in the managed care space. SB 1120, sponsored by the California Medical...more
Although this blog focuses mainly on the federal False Claims Act (FCA), other antifraud statutes feature in the qui tam relator and government enforcement toolkit. Key among them: the California Insurance Frauds Prevention...more
Hospitals and other health care providers work hard to eliminate billing and coding errors, but mistakes still happen. When those mistakes occur, health plans sometimes try to capitalize on the error by using it as a basis to...more