Georgia health system pays $35M to settle false claims allegations; Trial underway for Florida ophthalmologist accused of intentionally misdiagnosing patients;

News From Around the Web

> Columbus Regional Healthcare System in Georgia has agreed to pay $25 million, plus as much as $10 million in contingent payments, to settle allegations that the hospital billed for services at a higher level than they were provided. Additionally, Andrew Pippas, M.D., agreed to pay $425,000 to resolve similar allegations. Announcement

> A trial is underway for a Florida ophthalmologist charged with 20 counts of Medicare fraud for unnecessary laser treatments on patients he said had macular degeneration, the Orlando Sentinel reports. According to prosecutors, David Ming Pon lied to patients, telling them they suffered from the degenerative eye disease and convincing them to undergo laser treatments, which led to $7 million in improper Medicare payments. The case is similar to charges brought against Salomon Melgen, infamously indicted for billing Medicare $105 million for tests and procedures related to macular degeneration. Article

> The administrator of a Chicago-based company that specialized in physician home visits was sentenced to 87 months in prison and ordered to pay $1.3 million in restitution for his role in a fraud scheme. Rick Brown, president of Home Care America Inc., which managed Medicall Physicians Group Ltd., was convicted of billing Medicare more than $4 million for services that weren't provided and for physicians whoprovided more than 24 hours of services in a day. Announcement

Health Payer News

> Industry groups have criticized the Cybersecurity Bill of Rights drafted by the National Association of Insurance Commissioners. The organization created the guidelines to provide information for insurers and consumers following a data breach. Critics say the document is confusing for consumers and insurers and may include obligations that go beyond state law. Article

Health Finance News

> A new survey shows that hospital charges for the same procedure vary depending on whether a patient is insured or uninsured, and who they are insured by. For example, at one hospital, a knee arthroscopy would range from $13,452 to $19,187, but insurers paid anywhere between $2,681 and $13,607. Former hospital CEO Paul Levy says the discrepancy depends on "market power" and prices are usually higher for national companies as opposed to local insurance companies. Article

And finally… In case you were wondering, your cat is just fine without you. Article

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