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Feds find 3 SC parties accountable for $114 million healthcare fraud scheme

Feds find 3 SC parties accountable for $114 million healthcare fraud scheme Floyd Calhoun “Cal” Dent, III, of Lexington, and his two co-conspirators will continue to be held liable for defrauding Medicare and Tricare. (Source: Gray News) By Riley Bean | March 8, 2021 at 11:51 AM EST - Updated March 8 at 11:51 AM CHARLESTON, S.C. (WCSC) - The US Attorney for the District of South Carolina says the court of appeals has affirmed their $114 million judgement against one man and two testing labs found liable for defrauding federal health care programs. Floyd Calhoun “Cal” Dent, III, of Lexington, and his two co-conspirators will continue to be held liable for defrauding Medicare and Tricare.

The New Stark Law Value-Based Exceptions Seek to Advance the Shift from Volume to Value in the Delivery of Health Care in the United States | Butler Snow LLP

Value-based arrangement means an arrangement for the provision of at least one value-based activity for a target patient population to which the only parties are (1) the value-based enterprise and one or more of its VBE participants; or (2) VBE participants in the same value-based enterprise.” As previously noted, only “compensation arrangements” (and not ownership or investment arrangements) qualify as “value-based arrangements” for purposes of the new value-based exceptions. Further, only those compensation arrangements between a physician (or an immediate family member of a physician) and an entity to which the physician makes referral for DHS (and not compensation arrangements between a payor and a physician) qualify as “value-based arrangements”. Of note, qualifying “value-based arrangements” must ultimately relate to a target patient population, but are

CMS offers correct billing tips for nonphysician outpatient services provided before or during inpatient stays | Health Care Compliance Association (HCCA)

[6] “Medicare Does Not Pay Acute-Care Hospitals for Outpatient Services They Provide to Beneficiaries in a Covered Part A Inpatient Stay at Other Facilities (PDF)” [7] MLN Matters article. 1 “Non-Physician Outpatient Services Provided Before or During Inpatient Stays: Bill Correctly,” Fast Facts, Medicare Learning Network, Centers for Medicare & Medicaid Services, December 21, 2020, http://go.cms.gov/3ivCwRe. 2 Amy J. Frontz, “Medicare Made $11.7 Million in Overpayments for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient Stays,” Office of Inspector General, U.S. Department of Health & Human Services, May 2020, https://go.usa.gov/xvvkt. 3 “FAQs on the 3-Day Payment Window for Services Provided to Outpatients Who Later Are Admitted as Inpatients,”

Kodiak Sciences Announces Fourth Quarter and Full Year 2020 Financial Results and Recent Business Highlights

Kodiak Sciences Announces Fourth Quarter and Full Year 2020 Financial Results and Recent Business Highlights News provided by Share this article Share this article PALO ALTO, Calif., March 1, 2021 /PRNewswire/  Kodiak Sciences Inc. (Nasdaq: KOD), a biopharmaceutical company committed to researching, developing and commercializing transformative therapeutics to treat high prevalence retinal diseases, today reported business highlights and financial results for the fourth quarter ended December 31, 2020. Our Phase 1b data show two in every three patients are on a 6-month or longer treatment free interval at Year 1 in each of the three major retinal vascular diseases after only three loading doses , said Victor Perlroth, MD, Chief Executive Officer of Kodiak. Importantly, the durability profile of KSI-301 is tied to strong efficacy improvements in all three diseases at Year 1. The treatment naïve wet AMD patients in our study achieved 20/40 vision on average at Year 1 and DME

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