News & Insights


Changes in False Claims Act Make it easier to get in Hot Water with Federal Agencies

Recent changes to the federal False Claims Act have broadened the law, creating more ways for government contractors to find themselves in violation, say attorneys for Huntsville law firm Wilmer & Lee, speaking at a recent workshop for the 2014 GovCon conference at the Jackson Center. There are a number of ways contractors can get into trouble, including Service Contract and Davis-Bacon Act violations. Read more.

After Surgery, Surprise $117,000 Medical Bill from Doctor He Didn’t Know

In operating rooms and on hospital wards across the country, physicians and other health providers typically help one another in patient care. But in an increasingly common practice that some medical experts call drive-by doctoring, assistants, consultants and other hospital employees are charging patients or their insurers hefty fees. Read more.

Miami-Dade County, Like Many Employers, Denied Tools to Trim Health Costs

As Miami-Dade County negotiates with labor unions over proposed changes to employee health insurance — potentially requiring a biweekly premium for employees who currently pay none and increasing premiums for others — health care price transparency has become increasingly critical for the county and its workers. Read more.

Reference Pricing: Can We Use It Safely?

Federal regulators recently asked for comments on whether, and how, they should keep insurers and self-insured plan sponsors from abusing reference pricing. Representatives for some insurers, insurance groups and employers asked regulators to go easy on plans that are experimenting with reference pricing. Sterling Boon, CEO of The Boon Group, says use of reference pricing is the only way to end the "Robin Hood mentality" that leads hospitals to use high fees from well-insured patients to pay for care for the uninsured. Read more.

Price Transparency for MRIs Increased Use of Less Costly Providers

In an insurer-initiated price transparency program where patients were informed of price differences among available MRI facilities and given the option of selecting different providers, the result was a $220 cost reduction (18.7 percent) per test and a decrease in use of hospital-based facilities from 53 percent in 2010 to 45 percent in 2012. This suggests that patients select lower-price facilities when informed about available alternatives. Read more.

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