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Cleveland Clinic Accused of Medicare Fraud in Lawsuit
A federal lawsuit accuses the Cleveland Clinic Health System of performing more tests and procedures on patients than necessary in order to obtain more Medicare payouts.
A federal lawsuit accuses the Cleveland Clinic Health System of performing more tests and procedures on patients than necessary in order to obtain more Medicare payouts.
The lawsuit, which was filed under seal in March 2014 but unsealed on Tuesday, says the health system performs tests "that have already been done to confirm a diagnosis that has already been made for the purpose of financial gain." It accuses the clinic of "improper and excessive billing."
The suit was filed under the False Claims Act, a law used to prosecute companies that defraud governmental programs. Under the law, a claim is brought by a plaintiff called a "relator," who files the case on behalf of the US government.
Read more: http://bit.ly/1xKh1MT
Source: cleveland.com
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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How Access to SMA Treatment Varies Globally and by Insurance Type
March 18th 2025Posters presented at the 2025 Muscular Dystrophy Association (MDA) Clinical & Scientific Conference show that therapeutic advances in treating spinal muscular atrophy (SMA) are not uniformly making it into the hands of patients who could benefit.
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The Impact of Cost Sharing on High-Value Care
March 14th 2025Michael Chernew, PhD, professor of health care policy and director of the Healthcare Markets and Regulation Lab, Harvard Medical School, shares how cost-sharing policies shape access to critical health care services and influence value-based insurance design.
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A Focus on MAHA, Lasting Changes to Health Care Programs for Trump’s Second Term
March 13th 2025The second Trump administration is expected to bring changes to Medicaid, Medicare Advantage, and the health insurance exchanges, as well as highlight the Make America Healthy Again (MAHA) movement, speakers at the Value-Based Insurance Design Summit said.
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