The Justice Department announced yesterday that Healogics, Inc. has agreed to pay up to $22.51 million to settle allegations that it violated the False Claims Act by knowingly causing wound care centers to bill Medicare for medically unnecessary and unreasonable hyperbaric oxygen (“HBO”) therapy. Healogics, a Florida-based company, manages nearly 700 hospital-based wound care centers across the country. (Justice.gov)
Healogics, Inc. also agreed to pay $398,162.69 to resolve False Claims Act allegations pertaining to improper coding, the U.S. Attorney’s Office in the Northern District of Iowa announced yesterday. Specifically, the United States alleged that, from January 1, 2012, through June 30, 2017, Healogics submitted claims to Medicare, Medicaid, and Tricare using Modifier 25 to signify that a separate evaluation and management service was performed on the same date as another procedure when no such separate service was performed. (Justice.gov)
Yesterday, New York Attorney General Barbara D. Underwood and Massachusetts Attorney General Maura Healey released the following statement: “Yesterday’s announcement by the Trump Administration to dramatically expand the footprint of Association Health Plans will invite fraud, mismanagement, and deception – and, as we’ve made clear, will do nothing to help ease the real healthcare challenges facing Americans. We believe the rule, as proposed, is unlawful and would lead to fewer critical consumer health protections. We will sue to safeguard the protections under the Affordable Care Act and ensure that all families and small businesses have access to quality, affordable health care.” (AD.NY.gov)
CMS issued an RFI yesterday regarding the Physician Self-Referral Law. The introduction explained: "Through internal discussion and input from external stakeholders, CMS has identified some aspects of the physician self-referral law as a potential barrier to coordinated care. Addressing unnecessary obstacles to coordinated care, real or perceived, caused by the physician self-referral law is one of CMS’s goals in this Regulatory Sprint. To inform our efforts to assess and address the impact and burden of the physician self referral law, including whether and, if so, how it may prevent or inhibit care coordination, we welcome public comment on the physician self-referral law and, in particular, comment on the questions presented in this Request for Information."
Global health service company Cigna announced today that it is intensifying its commitment to curtail the opioid epidemic by focusing new drug prevention and treatment efforts in targeted U.S. communities. The company will collaborate with employers, customers, prescribing clinicians, pharmacists and community-based organizations to reduce the number of opioid overdoses by 25% among its commercial customers in these communities by December 2021. (Cigna.com)