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CMS Issues Proposed Rule on Changes to Stark In-Office Ancillary Services Exception

Section 6003 of the Patient Protection and Affordable Care Act, Public Law 111-148 (H.R. 3590) makes a change to the "in-office ancillary services" exception to the Stark physician self-referral law that impacts physician practices providing certain radiology services in their…

Michigan Clinic Owner Sentenced to Four-and-a-Half Years in Prison for Kickback Scheme, Submitting Fraudulent Claims

Carlos Grana, the operator of a Detroit-area medical clinic, was sentenced to 56 months in prison for defrauding Medicare, according to a news release by the Department of Justice.

Illinois Governor Pat Quinn Creates Healthcare Reform Council to Assist in Healthcare Reform Implementation, Make Recommendations

Illinois Governor Pat Quinn has signed an executive order to create a healthcare reform council that will help the state implement healthcare reforms contained in the federal Affordable Care Act, according to a news release by Governor Quinn's office.

AmkaiSolutions Hires Senior Vice President of Client Services

AmkaiSolutions has announced the hiring of Frank Doto as its senior vice president of client services.

Compliance With Health Reform Law Could Cost Insurers More Than Expected

A study by Weiss Ratings, a provider of independent insurance company ratings, suggests that compliance with the new healthcare reform law could cost insurers more than previously expected, according to a Weiss news release.

RACs to Begin Medical Necessity Review Audits

CMS has approved medical necessity review audits by recovery audit contractors, according to a report by AHA News Now.

ASC Industry Leader to Know: Lisa Rock of National Medical Billing Services

Lisa Rock serves as president of National Medical Billing Services in St. Louis, Mo., one of the largest ASC billing companies in the country. With more than 25 years experience in the industry, she has a unique and intimate perspective…

Second Task Force in Florida Created to Combat Healthcare Fraud

The National Insurance Crime Bureau announced the establishment of a second major medical fraud task force in Florida to counter the increase and spread of medical fraud in the state, according to an NICB news release.

Kansas Attorney General: $22M Recovered From Healthcare Fraud Last Year

A recent report shows that approximately $22 million was recovered last year from fraud and abuse of the Kansas' Medicaid program, according to a news release by the Kansas Attorney General's office.

Illinois Cardiologist Sentenced to 5 Years in Prison for Fraud

Sushil Sheth, MD, a former Chicago-area cardiologist, has been sentenced to five years in prison and ordered to pay $13 million in restitution for defrauding public and private health insurers, according to Chicago Tribune report.