GE Healthcare has paid the U.S. $30 million, plus interest, to settle allegations that a company it acquired in 2004, Amersham Health, had violated the False Claims Act by causing Medicare to overpay for Myoview, a radiopharmaceutical used in certain cardiac diagnostic imaging procedures, according to the U.S. Department of Justice.
The Department of Health and Human Services released a bulletin Dec. 15, outlining proposed policies that will give states more flexibility and freedom to implement the Patient Protection and Affordable Care Act (PPACA).
An Institute of Medicine (IOM) committee has made six recommendations to the Department of Health and Human Services (HHS), for the process of defining essential health benefits (EHBs), mandated under the Patient Protection and Affordable Care Act (PPACA). The HHS sought recommendations from the IOM in defining EHBs offered by health plans participating in newly created state health insurance exchanges.
The Department of Health and Human Services (HHS), along with several association and industry partners, has launched Million Hearts, an initiative that aims to prevent one million heart attacks and strokes in the U.S. over the next five years. Currently, cardiovascular disease (CVD) costs $444 billion every year in medical costs and lost productivity for people living in the U.S.
In the hot-bed of the Patient Protection and Affordable Care Act (PPACA) legal arena, two appeals court decisions were filed on Aug. 12 indicating the fractious nature of the constitutionality of the individual mandate provision.
Written by Brian Dunham
The Institute of Medicine (IOM) recommended the FDA scrap its 35-year-old 510(k) medical device clearance process and start anew, according to the findings of an evaluation released July 29, which chided the process as “flawed, based on its legislative foundation.”
A federal district court has convicted 41-year-old Radiologist Rajashakher P. Reddy, MD, of more than 30 counts of fraud and obstruction of justice in connection with his signing tens of thousands of radiology reports that neither he nor any other physician actually viewed.
SAN ANTONIO—According to the Centers for Medicare & Medicaid Services (CMS), all non-hospital providers of advanced diagnostic imaging, inclusive of nuclear medicine, MR, CT and PET, must obtain accreditation as a condition for reimbursement by Jan. 1, 2012. Just who is authorized to offer such accreditation was the subject of a June 26 afternoon presentation at the 2011 Association for the Advancement of Medical Instrumentation (AAMI) conference & expo.
Self-referring physicians are 2.5 times more likely to order imaging exams on patients than physicians without financial stakes in imaging orders, resulting in an estimated $3.6 billion in additional healthcare costs each year, according to a study published in the July issue of the Journal of the American College of Radiology.
In its June report to Congress, the Medicare Payment Advisory Commission (MedPAC) recommended reduced reimbursement, payment bundling and prior authorization for medical imaging services.
A West Palm Beach, Fla. radiology practice will pay the U.S. government $3 million to settle charges that it submitted false Medicare claims as part of illegal service agreements with referring physicians. A pair of radiologists who initiated the investigation will receive a $600,000 settlement.
Radiology benefit managers (RBMs) are assuming an increasing role in the utilization of imaging, but as the authorization system makes its way into more hospitals and national healthcare policy, a study published in the June issue of the Journal of the American College of Radiology questions the cost-effectiveness of RBMs and points to substantial cost shifting to providers.
Medicare erroneously covered nearly 1.5 million outpatient ED imaging exams in 2008, resulting in $38 million of reimbursements for interpretations that were either incomplete or noncompliant with Centers for Medicare & Medicaid (CMS) rules, according to a Department of Health and Human Services report. In response, CMS vowed to fix most gaps, while disagreeing with one of the department’s key recommendations.
Written by James Brice
Small studies assessing the efficacy of coronary CT angiography (CCTA) to diagnose or rule out coronary artery disease (CAD) have been the staple reference standard for its adoption. But a new era of comparative-effectiveness research is unfolding as CCTA will be tested against other validated cardiac imaging modalities, in particular, SPECT myocardial perfusion imaging (MPI).
The Institute of Medicine (IOM) has released two reports that recommend standards for developing systematic reviews and promoting clinical practice guidelines.
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