The Daily Scan

June 11, 2018

Last Updated: 10:15 AM EST

Litigation

  • Signature HealthCARE, LLC, a Louisville, Kentucky based company that owns and operates approximately 115 skilled nursing facilities, including 7 in middle Tennessee, has agreed to resolve allegations that it violated the False Claims Act by knowingly submitting false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary and skilled, the Department of Justice announced today. Under the settlement agreements, Signature has agreed to pay more than $30 million. (Justice.gov)

 

  • Two Iowa ACLU clients, Carol Ann Beal and EerieAnna Good, on Thursday won a lawsuit that successfully challenged an Iowa Department of Human Services (DHS) ban on Medicaid coverage for medically necessary surgical care for transgender Iowans. The court found that the ban violates the Iowa Civil Rights Act and Iowa’s state constitution. It ordered that DHS should act right away to approve the clients’ physicians requests for pre-approval of coverage under Medicaid. (ACLU-IA.org)

 

  • California Attorney General Xavier Becerra on Thursday led a coalition of 16 Attorneys General opposing a motion by the state of Texas and 18 other states in Texas et al. v. United States et al. seeking to halt operation of the Affordable Care Act (ACA) nationwide. “The lawsuit initiated by Texas is dangerous and reckless and would destroy the ACA as we know it. It would leave millions of Americans without access to affordable, quality healthcare. It is irresponsible and puts politics ahead of working families,” said Becerra. (OAG.CA.gov)

 

  • A Philadelphia behavioral specialist and mobile therapist charged with Medicaid fraud of more than $210,000 involving three different facilities pleaded guilty on Thursday in Delaware County Court. As part of the scheme, the therapist falsified the medical records of autistic children and submitted fake claims for reimbursement. (AttorneyGeneral.gov)

Legislation

  • On June 8th, members of both the Democratic and Republican parties as well as both chambers announced a deal on a bill aimed at cracking down on imports of powerful synthetic opioids from overseas. The new version of the bill, known as the STOP Act, would require the U.S. Postal Service to obtain electronic data on international mail shipments. This would be used to target suspicious packages for inspection in an attempt to crack down on the amount of Fentanyl entering the U.S., a major cause of overdoses. (WaysAndMeansForms.House.gov)

Regulation

  • Today CMS released an Informational Bulletin that provides states with information they can use when designing approaches to covering critical treatment services for Medicaid eligible infants with Neonatal Abstinence Syndrome (NAS). Additionally, CMS issued a letter to states on how they may best use federal funding to enhance Medicaid technology to combat drug addiction and the opioid crisis. (CMS.gov: Bulletin, Letter)

Private Sector

  • UnitedHealthcare, the insurance arm of UnitedHealth Group, will acquire Peoples Health, a Metairie, La.-based Medicare Advantage plan, for an undisclosed amount. Since providers launched Peoples Health in 1994, the health plan has grown from 3,200 members to 63,000. The health plan has about 850 employees and posted revenues of $710 million in fiscal year 2016. (BeckersHospitalReview.com)

 

  • Envision Healthcare Corporation today announced it has entered into a definitive agreement to be acquired by global investment firm KKR in an all-cash transaction for approximately $9.9 billion, including the assumption or repayment of debt. Under the terms of the agreement, which has been unanimously approved by Envision's Board of Directors, KKR will acquire all of the outstanding shares of Envision's common stock for $46.00 per share in cash. (Media.KKR.com)

 

 

 

 

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