The Daily Scan

June 6, 2018

Last Updated: 11:00 AM EST

Medicare

  • CMS released the 2018 Medicare Trustees Report on Tuesday, which most notably revealed that Medicare Hospital Insurance Trust Fund will be depleted by 2026, three years earlier than indicated in last year's report. This is being attributed to "lower payroll taxes attributable to lowered wages for 2017 and lower levels of projected GDP, and lower income from the taxation of Social Security benefits as a result of legislation." (CMS.gov)

 

  • Yesterday the OIG at the Department of Health and Human Services released 2017 Performance Data for the Senior Medicare Patrol Projects, which receive grants from the Administration for Community Living to recruit and train retired professionals and other senior citizens to recognize and report instances or patterns of health care fraud. Notable results from 2017 include $2,010,475 in expected Medicare recoveries that were attributable to the projects; $211,749 in cost avoidance on behalf of Medicare, Medicaid, beneficiaries, and others; and $44,468 in total savings to beneficiaries and others. (OIG.HHS.gov)

Research 

  • CMS announced yesterday that the AHRQ National Scorecard on Hospital-Acquired Conditions: Updated Baseline Rates and Preliminary Results 2014–2016 was released. The report intends to demonstrate progress toward the goal of reducing hospital-acquired conditions (HACs), or conditions that a patient develops while in the hospital being treated for something else. This most recent edition shows that from 2014 to 2016, HACs fell by 8 percent, saving about 8,000 lives and about $2.9 billion in healthcare costs. (CMS.gov, AHRQ.gov, Report)

 

Litigation

  • Dr. Michael Frey, M.D., a practicing interventional pain management specialist based in Fort Myers, FL, has pleaded guilty to two counts of conspiracy to receive healthcare kickbacks. He faces a maximum penalty of five years in federal prison for each count. Dr. Frey also faces a term of supervised release of up to three years for each count. A sentencing date has not yet been set. In addition to his guilty plea, Dr. Frey has agreed to a civil settlement under which he will pay $2.8 million to the United States to resolve allegations that he violated the False Claims Act in a number of ways, including receiving illegal kickbacks and by ordering medically unnecessary laboratory tests. (Justice.gov)

 

  • A federal grand jury sitting in Greensboro, North Carolina returned an indictment, which was unsealed today, charging the operators of a mental health provider with multiple crimes related to the submission of false claims to Medicaid and tax evasion, announced Principal Deputy Assistant Attorney General Richard E. Zuckerman and U.S. Attorney Matthew G.T. Martin for the Middle District of North Carolina. Catinia Farrington and Haydn Thomas, both formerly of Durham, North Carolina, are charged with conspiracy to commit health care fraud, health care fraud, aggravated identity theft, and tax evasion. Thomas is also charged with one count of money laundering. (Justice.gov)

Private Sector

  • athenahealth, Inc., a leading provider of network-enabled services for hospital and ambulatory customers nationwide, today announced that its Board of Directors has initiated a process to explore strategic alternatives, including a sale, merger or other transaction involving the Company as well as continuing as an independent company, due to Jonathan Bush stepping down as CEO, President, and Director amid abuse and misconduct allegations (athenahealth.com).

 

 

 

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