Saturday, July 11, 20260 Stories Today
Legal·NC·1d ago
North Carolina Woman Pleads Guilty to $1.7 Million Medicaid Urine Testing Fraud
A North Carolina woman pleaded guilty to defrauding Medicaid of $1.7 million through fraudulent urine testing claims. The scheme involved billing for unnecessary or unperformed laboratory testing services. The case represents ongoing federal and state enforcement activity targeting laboratory billing fraud in Medicaid programs. Medicaid managed care organizations that reimburse laboratory services should review utilization patterns and billing practices for urine drug testing to identify potential fraud.
Federal Policy·1d ago·jdsupra.comCMS Issues Claims Attachment Rule Establishing HIPAA Standards for Electronic DocumentationIndustry·1d ago·Home Health Care NewsDementia Costs Projected at $818 Billion in 2026, Threatening Home Health WorkforceIndustry·IA·1d ago·Becker'sCommonSpirit Closes Labor and Delivery Services at Iowa HospitalIndustry·1d ago·Becker'sSturgis Hospital Closes After 101 Years as 720 U.S. Hospitals Face Closure RiskLegal·OH·1d ago·ohiocapitaljournal.comFederal and Ohio Officials Highlight Individual Medicaid Fraud Cases While Corporate Enforcement LagsFederal Policy·1d ago·Federal RegisterCMS Approves Joint Commission for Continued HHA Accreditation Through 2026State Policy·WA·1d ago·KFF Health NewsWashington State Launches First Public Long-Term Care Benefit ProgramState Policy·MI·1d ago·bridgemi.com+1 moreMichigan Prepares for Federal Medicaid Changes as 400-Page Guidance ReleasedState Policy·1d ago·KFF ResearchFirst 1115 SUD IMD Waiver Evaluations Show Mixed Progress on State MilestonesLegal·2d ago·FoleyCourt Dismisses False Claims Act Case on Medicare Advantage Marketing PracticesIndustry·2d ago·MedCity NewsMenopause Complications Drive Utilization in Chronically Ill PopulationsIndustry·2d ago·KFF ResearchACA Marketplace Insurers Propose 14% Premium Increase for 2027Managed Care·2d ago·KFF ResearchContraceptive Implant Use Rising Despite Remaining Below Other Birth Control MethodsFederal Policy·2d ago·KFF ResearchACS Data Shows Direct Care Worker Demographics Amid Federal Policy ShiftsFederal Policy·2d ago·aha.org+1 moreCMS Ends Fast-Track Review Process for Medicaid 1115 Waiver ExtensionsState Policy·OK·2d ago·oklahomavoice.comOklahoma Shifts State Behavioral Health Services to Four Private ProvidersState Policy·VA·2d ago·virginiamercury.comVirginia Budgets $15M for Medicaid Sickle Cell Gene Therapy CoverageManaged Care·2d ago·stateline.org+2 moreMedically Tailored Meals Reduce Hospital Use for Medicaid Enrollees, Study FindsIndustry·2d ago·Healthcare DiveExternal Audit Finds 97% of UnitedHealth HouseCalls Diagnoses Supported by Medical RecordsFederal Policy·3d ago·jdsupra.comCMS Proposes Rule Codifying Medicare Drug Price Negotiation ProgramState Policy·AZ·3d ago·azmirror.comArizona Democrats Report Coverage Losses One Year After Federal Budget ReconciliationState Policy·MN·3d ago·minnesotareformer.comMinnesota Counties Report Administrative Strain from Medicaid Renewal ProcessingIndustry·3d ago·STAT NewsTrump Officials Press Drug Industry to Onshore Generic ManufacturingIndustry·3d ago·Home Health Care NewsUnitedHealth HouseCalls Program Reduces Hospitalizations by 5%, ER Visits by 4%Legal·3d ago·Becker'sFour Major Pharmacy Litigation Tracks Progress: PBM Ownership, 340B, Antitrust, FraudIndustry·3d ago·Becker'sSafety Net CIOs Tighten IT Spending Amid Medicaid Budget ReductionsFederal Policy·3d ago·The HillFDA Approves Gene Therapy for Children with Sickle Cell DiseaseFederal Policy·3d ago·Georgetown CCFCMS Requests State Medicaid Provider Revalidation Strategies in April Administrator LetterManaged Care·3d ago·KFF Health NewsSome Health Plans Exclude Manufacturer Copay Assistance from Deductible and Out-of-Pocket MaximumsIndustry·3d ago·STAT NewsFDA Approves Over-the-Counter CGM for Childhood Obesity ManagementManaged Care·3d ago·The HillGLP-1 Weight Loss Use Jumps to 11% of Americans in Two YearsIndustry·3d ago·Becker'sFour Health Plans Expand Specialty Pharmacy Strategies to Address Drug Cost GrowthState Policy·CA·4d ago·National Health Law+2 moreCalifornia Launches Birthing Care Pathway to Improve Medicaid Maternity OutcomesLegal·4d ago·Becker's5,000 Independent Pharmacies Sue Prime Therapeutics for Alleged Antitrust ViolationsFederal Policy·4d ago·Becker'sCMS Launches Medicare GLP-1 Bridge Program with Fixed-Cost AccessIndustry·4d ago·Becker'sYale Study Finds Most Telehealth GLP-1 Vendors Skip Live Clinician VisitsIndustry·4d ago·MedCity NewsMedCity News Op-Ed Calls for Unified Governance in Health Data ExchangeLegal·NY·4d ago·jdsupra.comHHS-OIG Denies Recertification for New York Medicaid Fraud Control Unit, Freezes $60 MillionState Policy·IN·4d ago·indianacapitalchronicle.comIndiana to Implement Medicaid Work Requirements Starting January 2027Federal Policy·4d ago·spotlightpa.orgHHS Postpones Preventive Services Task Force Meetings, Plans August Reboot with Eight New MembersState Policy·CO·4d ago·Georgetown CCFColorado Maternal Health Initiative Leader Discusses Perinatal Care Transformation Under MedicaidFederal Policy·4d ago·Georgetown CCFProposed Medicaid Work Requirements Face Rural Service Delivery ChallengesFederal Policy·4d ago·MedCity NewsCMS Proposes 2.4% Outpatient Rate Increase With 340B Cuts and Site-Neutral Imaging ExpansionManaged Care·4d ago·MedCity NewsStates Urged to Modernize Program Integrity in Medicaid Self-Directed Care ProgramsState Policy·IN·4d ago·indianacapitalchronicle.comIndiana Maintains Medicaid Funding Block to Planned Parenthood After Federal Ban ExpiresFederal Policy·4d ago·shvs.org+2 moreSHADAC Releases Administrative Cost Monitoring Guide for H.R.1 Medicaid ImplementationFederal Policy·4d ago·Federal RegisterCMS Re-Establishes Data Match With VA to Verify Minimum Essential Coverage for Marketplace Eligibility
Page 1 of 14