The Daily Scan

May 18, 2018

Last Updated: 10:20 AM EST

Litigation

 

  • The owner of a Michigan home health agency pleaded guilty yesterday to fraud charges for his role in a scheme involving approximately $8 million in fraudulent Medicare claims for home health services that were procured through the payment of illegal kickbacks. (Justice.gov)

 

  • On Wednesday, an in-home health assistant from Carbondale, Illinois, was sentenced in the U.S. District Court in Benton, Illinois on the charge that she engaged in a scheme to steal from a health care program. Court records indicate that Stephanie Patterson defrauded the State of Illinois Medicaid Home Services Program by falsely claiming and taking payments for personal assistant services not actually performed. (Justice.gov)

 

  • A Kansas woman was sentenced Wednesday to more than a year in prison and ordered to repay more than $12,000 to the Kansas Medicaid Program after pleading guilty to Medicaid fraud-related charges. An investigation by the attorney general’s Medicaid Fraud and Abuse Division revealed that Jennifer Flores billed Medicaid for services provided as a personal care attendant for a Medicaid beneficiary, who was disabled and eligible for home-based services, while the beneficiary was hospitalized or while the defendant was incarcerated. (AG.KS.gov)

Medicare

 

  • A new in-depth report on Medicare Part D from the Kaiser Family Foundation revealed that as of 2018, three Medicare Part D plan sponsors—UnitedHealth, Humana, and CVS Health—account for more than half of the program’s 43 million Part D enrollees (55%) and two-thirds of all stand-alone drug plan enrollees, indicating a marketplace that is dominated by a handful of major insurers. Pending mergers would consolidate these sponsors further. (KFF.org)

 

Regulation

 

  • A New York Times investigation published yesterday revealed that medical researchers have begun experimenting with using emergency contacts gathered from medical records to build family trees that can be used to study the heritability of hundreds of different attributes, and possibly advance research into diseases and responses to medications. While the intention of the researchers was to further knowledge of genetics, their approach is contributing to an ongoing dialogue on bioethics and patient consent. (NYTimes.com)

 

  • Yesterday the FDA approved Aimovig for the preventive treatment of migraine in adults. Aimovig is the first FDA-approved preventive migraine treatment in a new class of drugs that work by blocking the activity of calcitonin gene-related peptide, a molecule that is involved in migraine attacks. The treatment is given by once-monthly self-injections. (FDA.gov)

Technology

 

  • Acting VA Secretary Robert Wilkie announced yesterday that the agency has officially signed a contract with Cerner that will "modernize the VA’s health care IT system and help provide seamless care to Veterans as they transition from military service to Veteran status, and when they choose to use community care." This is one of the largest IT contracts in the federal government, with a ceiling of $10 billion over 10 years. (VA.gov)

 

 

 

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