Category: CMS

Explore our library of blogs, insights, research papers, and more information on compliance in the life sciences industry.

DOJ and CMS Increasing Focus on Health Care Fraud

In the past couple of years, law enforcement agencies have recovered billions of dollars through judgments and settlements related to healthcare fraud investigations. In the fiscal year 2015, the DoJ recovered more than $3.5 billion in judgments and settlements from cases that involved fraud and false claims against the government. As time goes by, government […]

CMS to Add Data Analytics Lead to Its Employees Pool

Data is the buzzword these days. With the vast amounts of healthcare data held by the Centers for Medicare & Medicaid Services (CMS), the organization has deemed it necessary to move away from the generic data scientist role to a specific big-data-related role to enhance healthcare delivery and detect cases of fraud through efficient statistical […]

Transparency Data and Law Enforcement Authorities: The Dynamic Duo

Open Payments is a national program that is focused on promoting transparency by making data on the financial relationships between the healthcare industry (applicable manufacturers and group purchasing organizations or GPOs) and healthcare providers (physicians and teaching hospitals) publicly available. With such extensive data published every year, enforcement authorities have literally acquired a gateway to […]

CMS Data Deep Dive: $15,000 for a Single Meal

– The highest single transaction for physician meal in 2015 reported to CMS is: $15,000 (even). – The highest single transaction for physician meal in 2014 reported to CMS is: $17,176. How is this possible? How can a single physician eat a single meal worth $10k or more? Is this data for real? I asked […]

Indictment of Novartis Korea Executives Over Rebates

Prosecutors have indicted six executives from the South Korean unit of Novartis for paying rebates to doctors so they may prescribe the company’s drugs to patients. Twenty-eight other individuals, including fifteen doctors and six medical publishers, were also part of the prosecutorial sweep. The six executives who were prosecuted include Novartis Korea chief Moon Hak-sun. […]

Highlights of 10th Annual Forum on Transparency & Aggregate Spend

CBI held the 10th Annual Forum on Transparency and Aggregate Spend at the Ritz-Carlton in Washington, D.C. from 15th – 17th August, 2016. The forum provided an excellent opportunity for pharmaceutical, biotech, and medical device executives to connect and share information about best practices pertaining to Federal, State, and worldwide HCP reporting. The conference delivered […]