AIS's Health Business Daily
Strategic Business News from Experienced Health Care Reporters
at Atlantic Information Services, Inc.
Report on Medicare Compliance
Today’s issue is brought to you by AIS's Report on Medicare Compliance, the nation's leading source of news and strategic information on Medicare compliance, Stark and other big-dollar issues of concern to health care compliance officers.

August 22, 2014

Today's Featured Story

CHS Hospitals Settle False Claims Act Case for $98 Million Over Short Stays From the ER
Reprinted from Report on Medicare Compliance

About a year after Community Health Systems (CHS) bought Chestnut Hill Hospital in Philadelphia, its new CEO allegedly told emergency-room doctors they weren’t admitting enough patients. Then CHS replaced the longtime ER physician group, allegedly because it wasn’t on board with a corporate plan to increase inpatient admissions. When the new ER physician group took over, far more patients were admitted to the hospital, exactly what CHS allegedly intended all along, according to a false claims complaint filed by a former Chestnut Hill physician turned whistleblower.... Read Full Story


Quote of the Day

“I would characterize [talk in the industry about private exchanges] as more about hyper-interest and staggered growth [as opposed to “hyper growth”]. There is no doubt employers are interested in private exchange solutions, but they want to know more about what they are and what they entail.”

— Jonathan Har-Even, a manager in PwC’s Global Human Resource Services practice, told the audience at a recent AIS webinar.

Click here to read the HEALTH PLAN WEEK article in which this quote appeared. (Free for HPW subscribers; $17 for non-subscribers).


Today's Datapoint

99.7% ... of the information provided to insurance exchanges by the IRS to determine eligibility for subsidies was accurate, according to a glowing audit released Aug. 5 by the Treasury Inspector General for Tax Administration.



Today from Washington

People on the Move

Health Net, Inc. promoted James Woys to executive vice president, chief financial and operating officer, and interim treasurer. Woys had been executive vice president and chief operating officer since November 2007. Woys will replace current Chief Financial Officer (CFO) Joseph Capezza, who is retiring. Capezza will have a consulting contract with the company through the end of the year to assist with transition issues....WellCare Health Plans, Inc. named Andrew Asher senior vice president, effective Aug. 29, and expects the board to appoint him as CFO in November. Asher now is the CFO of Aetna, Inc.’s Local and Regional Businesses....Greg Scott, a principal with Deloitte Consulting LLP, was appointed principal vice chairman and national sector leader for Deloitte's health plans practice.


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