The strength of a company’s compliance program carries tremendous weight during a fraud investigation, particularly as prosecutors consider whether to pursue…

Health Net gets his with a $340,000 SEC fine for a severance policy that prohibited employees from collecting whistleblower awards.

Last week’s decision by a federal appeals court to revive a whistleblower's claims against five insurers offers new insight into how the courts view…

Federal investigators and prosecutors are mining CMS's Open Payments data to identify spending outliers and solidify whistleblower fraud claims.

A settlement in a Florida court case may signal good news for independent practices being squeezed by narrow networks’ referral policies.

Texas General Hospital has been known to charge more than $330,000 for a foot surgery. And it appears to be mostly deserted.

A federal investigation is focusing on healthcare providers that may be steering patients away from government plans and toward marketplace coverage in order…

As health insurance enrollment has risen under ACA, so, too, have the number of prescriptions patients fill. And they’re are paying less out of pocket to do so…

A federal appeals court upheld guilty verdicts against four former WellCare executives convicted of hiding proceeds from Medicaid managed care plans.