The Daily Scan

June 1, 2018

Last Updated: 11:15 AM EST

Litigation

  • The Community Oncology Alliance (COA) has filed a lawsuit in the U.S. District Court for the District of Columbia to stop the United States Department of Health and Human Services (HHS) and the White House Office of Management and Budget (OMB) from applying the Medicare sequester cut to reimbursement for Part B drugs. (CommunityOncology.org: Press Release, Complaint)

 

  • United States Attorney Gregory G. Brooker and Minnesota Attorney General Lori Swanson announced on Wednesday that Wal-Mart Stores, Inc. and Sam’s West, Inc. (d/b/a Sam’s Club) have agreed to pay a total of $825,000 to resolve allegations that they violated the False Claims Act and Minnesota False Claims Act by submitting claims for payment to Minnesota’s Medicaid program in violation of rules prohibiting Medicaid prescriptions from being automatically refilled. (Justice.gov)

 

  • On Tuesday, May 29, United States Attorney Louis V. Franklin, Sr. announced that a licensed professional counselor in Montgomery, AL was arrested after being indicted by a federal grand jury for her role in working at a "pill mill." The indictment charges the defendant with health care fraud and perjury offenses. (Justice.gov)

 

  • U.S. Attorney William M. McSwain announced yesterday that the owners of I&L Express Pharmacy in Philadelphia have agreed to pay $3.2 million to the federal government to resolve allegations that they violated the False Claims Act by billing Medicare for prescription medications that were not actually dispensed during the period January 1, 2009, through December 31, 2015. (Justice.gov)

 

  • A Pennsylvania appeals court agreed Thursday that the state’s open records law did not entitle UnitedHealthcare to documents detailing the scoring of bid proposals submitted by competitors, which the insurer requested to aid in a protest after the Department of Human Services rejected its bid. (Law360.com, PACourts.us)

Legislation

  • New Jersey Gov. Phil Murphy (D) on Wednesday night signed into law a bill imposing an individual mandate for health insurance to replace a federal requirement that Congress repealed. The move makes New Jersey the second state to require health-care coverage and impose a penalty on residents without it. (TheHill.com)

Regulation

  • CMS Administrator Seema Verma announced yesterday that 91% of all clinicians eligible for the Merit-based Incentive Payment System (MIPS) participated in the first year of the Quality Payment Program (QPP) – exceeding the agency's goal of 90% participation. (Blog.CMS.gov)

 

  • FDA Commissioner Scott Gottlieb, M.D. released a statement yesterday on new policies to reduce the ability of brand drug makers to use REMS programs as a way to block timely generic drug entry, helping promote competition and access. (FDA.gov)

 

 

 

 

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