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A case of Medicaid fraud was carried out in 2010 by an Armenian-American organized crime group called the Mirzoyan–Terdjanian organization. [1] [2] The scam involved a crime syndicate which created 118 fake clinics in 25 states and used stolen medical license numbers of real doctors and matched them to legitimate Medicare patients whose names and billing information were also stolen.
The Knox-Keene Health Care Service Plan Act of 1975 is a set of Californian laws that regulate Healthcare Service Plans. Under these laws, pharmacy benefit managers with contracts to Health care service plans are required by law to be registered with the Department of Managed Health Care to disclose information. [58] SB 966: Pharmacy benefits
The Institute for Clinical and Economic Review (ICER) is a Boston-based independent nonprofit organization that seeks to place a value on medical care by providing comprehensive clinical and cost-effectiveness analyses of treatments, tests, and procedures. [1] ICER was founded in about 2005 by physician-researcher Steven D. Pearson. [1]
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CareSource celebrated 25 years as one of the nation's largest Managed Medicaid Plans and the largest in Ohio in 2014. The company then served more than 1 million consumers in Ohio and Kentucky. [30] In 2019 and 2020, CareSource earned a high quality rating in the Ohio Department of Medicaid (ODM) Managed Care Plans Report Card. [31] [32]
Versa Networks issued an advisory on Monday acknowledging that the vulnerability had been exploited "in at least one known instance" by an advanced group of hackers, and urged customers to update ...
In the United States, an independent practice association (IPA) is an association of independent physicians, or other organizations that contracts with independent care delivery organizations, and provides services to managed care organizations on a negotiated per capita rate, flat retainer fee, or negotiated fee-for-service basis. [1] [2]