The U.S. Department of Justice (DOJ) sued NewYork-Presbyterian Hospital on Thursday, alleging the health system used insurer contract terms to block lower-cost health plan designs that could steer patients to competing providers, including ambulatory surgery centers (ASCs). The civil antitrust complaint, filed in the U.S. District Court for the Southern District of New York, claims that NewYork-Presbyterian violated Section 1 of the Sherman Act by restricting insurers from offering what the … [Read more...]
Forefront Dermatology, Henghold Surgery Center Settle False Claims Act Allegations for $847K
Forefront Dermatology and a now-closed ambulatory surgery center (ASC) have agreed to pay nearly $850,000 to resolve allegations they improperly billed Medicare for wound repair procedures, according to the U.S. Department of Justice (DOJ). The $847,394 settlement addresses claims that Forefront Dermatology S.C. and Henghold Surgery Center LLC violated the False Claims Act (FCA) by upcoding wound repair services tied to Mohs micrographic surgeries – an advanced technique used to treat skin … [Read more...]