Insurance Discrimination – Against the Provider

Insurance Discrimination – Against the Provider Author: Jeana M. Singleton, Esq.  When the concept of “insurance discrimination” rears its ugly head, we often think of it in the context of when an insurance company treats some people differently than others based on protected classes, such as race, national origin, sex, or religion.  Sometimes, this type…

Removing Ambiguity from CMS’s In-Home HRA Guidance: Lessons from Cigna’s $172 Million False Claims Act Settlement

December 22, 2023 | By: Edward Baker, Of Counsel | Lieff Cabraser Heimann & Bernstein On September 30, 2023, the U.S. Department of Justice announced a $172 million False Claims Act (FCA) settlement with Cigna relating to the submission of invalid HCC diagnosis codes to CMS in order to increase Medicare Advantage member risk scores, and therefore,…

How Laboratories Rendering Anatomic Pathology Services Can Comply with AKS

  November 17, 2023 | By Amanda Waesch This past September 2023, the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) issued Advisory Opinion 23-06 (AO).1 The Opinion involved a proposed arrangement between an independent pathology laboratory and third-party physician laboratories for the purchase of the technical component of…

When Interpreting Ambiguous Federal Healthcare Laws, Practice “Safe Driving”

  September 15, 2023 | By: Edward Baker, Of Counsel | Lieff Cabraser Heimann & Bernstein If you lie awake at night worrying about whether your coding, auditing, or compliance practices might be based on misinterpretations of federal law, opening up your healthcare employer—or yourself!—to treble damages and penalties under the False Claims Act (FCA), you may…