The Daily Scan

Last Updated: 1:45 PM EST

Litigation

• Amyotrophic Lateral Sclerosis (ALS) patient institutes legal action against Blue Cross Blue Shield of Illinois in United States District Court for the Northern District of Illinois alleging the plan breached its fiduciary duty under ERISA by failing to continue to cover private duty nursing services.

• Winnebago, Santee-Sioux, and Omaha Nations initiate opioid litigation against McKesson Corporation, et al. in United States District Court for the District of Nebraska alleging wrongful actions with regard to manufacture and distribution of opioid medications.

• Aetna Health Plan removes action filed by NYU Hospitals Center to United States District Court for the Southern District of New York based upon ERISA pre-emption. The action alleges breach of contract for denial of claims for hospital services furnished to health plan member.  

• A parent initiated a class action against Good Shepherd Medical Center in Longview, Texas after the center sought to collect charges of $25,308.92 for services provided to the child of the parent. The trial court dismissed the action after the hospital wrote off the bill. The Court of Appeals for the Sixth Appellate District of Texas overturned the decision of a trial court dismissing the Appellant’s class action claims and claims for attorney’s fees. (TXCourts.gov)

• The United States Justice Department filed civil complaints on May 9, 2018 in U.S. District Courts for the Central District of California and the Southern District of Florida alleging defendants manufactured stem cell based treatments for patients without approval of the Food and Drug Administration as required by law. 

Government Contracting

• Former Bureau of Prisons financial administrator agrees to pay $50,000 to resolve Anti-Kickback Act allegations for Bureau of Prisons contracts for management of healthcare networks which provided medical care to federal inmates. (Justice.gov)

Medicare & Medicaid

• As part of the agency's new Rural Health Strategy, CMS issued an interim final rule yesterday with comment period  to increase the fee schedule rates from June 1, 2018, through December 31, 2018, for certain durable medical equipment (DME) items and services and enteral nutrition furnished in rural and non-contiguous areas (Alaska, Hawaii, and U.S. territories) of the country not subject to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). (CMS.gov)

• The Louisiana Department of Health will begin mailing notices today to nearly 37,000 Medicaid enrollees informing them their eligibility may end on July 1, 2018. These official notices alert senior citizens and individuals with developmental disabilities who receive care in a nursing home, in other long-term care facilities and through waivers for community-based services that their benefits may end July 1 or upon federal approval. (ldh.la.gov)

• New Hampshire became the fourth state to institute a Medicaid work requirement yesterday, joining Indiana, Arkansas, and Kentucky. (TheHill.com)

• CMS released the 2018 Quality Measure Development Plan Annual Report, which describes progress in developing clinician quality measures to support the Quality Payment Program. (CMS.gov)

Private Sector

• Pharmaceutical company Novartis released a statement yesterday explaining a one-year, $1.2 million contract with Essential Consultants, the company led by President Trump's personal lawyer Michael Cohen. Novartis intended for Cohen to provide expertise on health care policy in light of the changing administration, but after the initial one-year term the contract was not renewed due to Cohen's inability to provide the services promised. (Novartis.com)