Legal / Regulatory / Risk Management

Latest Headlines

Latest Headlines

Medicaid, exchange churning to occur in all 50 states

So-called churning--where eligibility changes will occur between Medicaid and health insurance exchanges--is likely to be a major challenge in every state as Affordable Care Act implementation continues, a recent study finds.

CMS equalizes coverage for same-sex couples, HIV/AIDS patients

The Obama administration has strengthened health insurance protections for same-sex couples and HIV/AIDS patients.

Feds investigate 'patient dumping' law compliance

The U.S. Commission on Civil Rights convened last week to determine if hospitals across the country are violating the Emergency Medical Treatment and Labor Act by "dumping" mentally ill and other patients.

Ind. hospital to start its own police department

An Indiana hospital will form its own independent police department in an effort to ensure officers receive consistent training for the healthcare setting and so the hospital doesn't drain resources from community departments.

Get past the politics and repeal the SGR formula

Last month, when federal lawmakers--on a bipartisan basis--reached a deal to permanently repeal the sustainable growth rate formula, it seemed that it's end finally was at hand. But now, a month later, politics has reared its ugly head and threatens to derail that agreement.

MedPAC: Despite temporary drop, overall imaging volume up for the decade

While the imaging volume for Medicare beneficiaries temporarily fell from 2011 to 2012, the level at which these services are being used is still much higher than it was a decade ago.

Feds raid offices of radiology company implicated in Medicare fraud

Federal agents last week raided the corporate headquarters of a New York-based radiology company, seizing records associated with an investigation into allegations that the company engaged in fraud by overbilling Medicare for its services.

How to make CDS tools more effective for radiologists

The ideal clinical decision support system should reduce healthcare costs, patient radiation exposure and patient evaluation time without compromising healthcare standards or a patient's quality of life, according to an article in the March issue of the  Journal of the American College of Radiology.

Brookings: Reimbursement issues, murky regs top mHealth challenges

The top challenge facing mobile health technology innovation and adoption in the U.S. is the lack of federal health agency and healthcare payer reimbursement, according to a new report from the Center for Technology Innovation at the Brookings Institution.

3 reasons Minnesota's exchange failed

Minnesota's health insurance exchange, which still suffers from functionality and technical problems, could take up to two years to fix. As states consider moving to a state-based marketplace, MNsure's failure can offer lessons on what not to do.