Category archive: Civil Money Penalty

Fraud and Abuse Update: Inflation Adjusted Rate Hikes Coming Aug. 1 for False Claim Act and Anti-Kickback Civil Money Penalties

PROVIDERS TAKE NOTE: CIVIL MONEY PENALTIES FOR FALSE CLAIM ACT AND ANTI-KICKBACK STATUTE VIOLATIONS WILL NEARLY DOUBLE AUGUST 1ST The Department of Justice (DOJ) released an interim final rule recently to update the minimum and maximum civil money penalties (CMP) for violation of the False Claim Act (FCA). Providers should be aware that the increases…

CMS Takes Action Against Aetna Inc. for Erroneously Identifying “Retail In-Network” Pharmacies

On April 2, 2015, CMS issued notice of imposition of a $1 Million civil money penalty (CMP) against Aetna for errors reported in Aetna’s pharmacy network directory. Due to this error, many Aetna enrollees presented prescriptions to their pharmacy, only to discover that the pharmacy was not in their plan. The Medicare enrollees complained to…


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