BILLING AND CODING—SETTLEMENT... - VitalLaw.com
The government alleged Aetna knowingly submitted unsupported diagnosis codes, resulting in overpayments by Medicare. Aetna Inc. has agreed to pay a total of $117.7 million to resolve two separate ...
Spoiler alert. We are about to reveal the secret to learning what the U.S. Department of Labor's Employee Benefits Security Administration ("EBSA") will be focused on the next time it investigates...
Spoiler alert. We are about to reveal the secret to learning what the U.S. Department of Labor's Employee Benefits Security Administration ("EBSA") will be focused on the next time it investigates your employee benefit plans? Ready? Just ask.
Last week, EBSA announced an overhaul of its national enforcement projects for fiscal year 2026—the most significant EBSA has made in recent years—in some cases realigning them with statements previously made by the new administration. According to EBSA, national enforcement projects indicate the areas that will guide enforcement, suggesting that this is where EBSA will focus its attention in investigations.
So what are those national enforcement projects? They fall into several categories, many of which are expected, including the following:
Proskauer's Perspective: Plan sponsors and fiduciaries should continue to review and assess periodically the cybersecurity practices of providers that maintain or have access to participant and other sensitive data or funds and confirm that they have adequate contractual protections with those...
The government alleged Aetna knowingly submitted unsupported diagnosis codes, resulting in overpayments by Medicare. Aetna Inc. has agreed to pay a total of $117.7 million to resolve two separate ...