The Daily Scan

June 18, 2018

Last Updated: 9:45 AM EST

Litigation

  • Elizabeth Holmes, founder of private health care and life science company Theranos, and former Theranos President and COO Ramesh "Sunny" were indicted on Friday by a federal grand jury and charged with two counts of conspiracy to commit wire fraud and nine counts of wire fraud. The charges stem from allegations Holmes and Balwani engaged in a multi-million dollar scheme to defraud investors, and a separate scheme to defraud doctors and patients. Both schemes involved efforts to promote Theranos. According to a statement from the company, Holmes has stepped down as Chief Executive Officer, but remains with the Company as Founder and Chair of the Board. (Justice.gov, Theranos.com)

 

  • A Mississippi-based nurse practitioner pleaded guilty on Friday for her role in a scheme to defraud health care benefit programs including TRICARE, the health care benefit program serving U.S. military, veterans and their respective family members. Susan Perry prescribed medically unnecessary compounded medications to individuals who did not need the medications, sometimes without first examining those individuals. Perry admitted that she knew that Advantage Pharmacy, based in Hattiesburg, Mississippi, would submit claims for reimbursement to health care benefit programs, including TRICARE, for compounded medications based on the prescriptions she signed, and she further expected that the health care benefit programs would pay the claims. She is scheduled to be sentenced on September 20. (Justice.gov)

Regulation

  • On Friday, the Department of Health and Human Services (HHS) announced the availability of $350 million in new funding to expand access to substance use disorder and mental health services at community health centers across the nation.  These funds will support health centers in implementing and advancing evidence-based strategies, including expanded medication-assisted treatment (MAT) services, and are expected to be awarded in September of this year by HHS’s Health Resources and Services Administration (HRSA). (HHS.gov)

 

  • On Friday, the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency within the Department of Health and Human Services (HHS), announced that they are now accepting applications for $930 million in State Opioid Response Grants. SAMHSA will distribute funds to states and territories in support of their ongoing efforts to provide prevention, treatment and recovery support services to individuals with opioid use disorder. (HHS.gov)

 

  • The CMS has miscalculated hospitals' star ratings since they were first released in 2016, according to leaders at Rush University Medical Center in Chicago. Rush University wrote to the CMS expressing this concern in May when the CMS informed the system that it had fallen to a three-star rating, down from the five stars it had received in every previous release. Rush's findings likely prompted the CMS to announce this week that it would postpone the upcoming release of star ratings, originally scheduled for July. Rush officials exclusively disclosed their analysis and correspondence to Modern Healthcare. (ModernHealthcare.com)

Research

  • The National Institutes of Health plans to end funding to the Moderate Alcohol and Cardiovascular Health (MACH) trial. The decision is based on concerns about the study design that cast doubt on its ultimate credibility, including whether the study would effectively address other significant consequences of moderate alcohol intake, such as cancer. The decision to end funding is informed by recommendations of the Advisory Committee to the Director (ACD). The recommendations, based on findings of an ACD working group, also noted that significant process irregularities in the development of the funding opportunities for the MACH funding awards undermined the integrity of the research process. (NIH.gov)

 

  • According to a report released last week from the Milken Institute School of Public Health and the RCHN Community Health Foundation has found that between 2010 and 2016, community health centers experienced major patient growth. Data shows that over a six-year time span, health centers nationwide experienced a one-third (33%) patient growth. Within this overall figure, state-by-state growth varied significantly in terms of both overall percentage growth rates and the number of patients served. (PublicHealth.GWU.edu)

Private Sector

  • As a result of the changes from the Tax Cuts and Jobs Act (TCJA), Blue Cross Blue Shield companies (Blues) reported a total change of $4.7 billion to their net deferred income tax on their 2017 year-end statutory statement, according to a new A.M. Best briefing. The Best’s Briefing, “Positive Impact of Tax Reform for Blue Cross Blue Shield Plans,” states that the favorable impact to the net deferred income tax compared with $854 million at year-end 2016. However, due to the impact of the TCJA many of these companies also reported a negative change in the value of the deferred tax asset, which partially offset the change in the net deferred income tax. The net effect was a positive $2.3 billion for the Blues in aggregate. (AMBest.com)

 

 

 

 

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