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The Daily Scan

Last Updated: 8:50 AM EST


  • Health Quest Systems, Inc. and certain of its subsidiaries (Health Quest) and Putnam Health Center (PHC) have agreed to pay over $14.7 million to resolve allegations of violations of the False Claims Act by submitting inflated and otherwise ineligible claims for payment. In the settlement announced yesterday, Health Quest and PHC admitted, acknowledged, and accepted responsibility for certain facts involving the submission of improper claims for various health-related services, such as claims for evaluation and management services, home health services, and false claims for inpatient and outpatient services. (Justice.gov)


  • Maine lawmakers overturned Gov. Paul LePage’s veto to pass a sweeping medical marijuana reform bill. The Maine House voted 119-123 and the Maine Senate voted 25-8 to override the Republican governor’s veto and adopt legislation that will allow patients to use medical marijuana. “Maine’s medical cannabis program is already one of the best in the country,” said Sen. Eric Brakey, R-Auburn, who as co-chairman of the health and human services committee helped write the new law. “The passage of L.D. 1539 will make it even stronger. More access and choice for patients. More flexibility for legal businesses. And more integrity to the overall program.” (PressHerald.com)


  • Yesterday, FDA Commissioner Scott Gottlieb, released this statement on balancing access to appropriate treatment for patients with chronic and end-of-life pain, "While we work to ensure appropriate and rational prescribing of opioids, we won’t lose sight of the needs of Americans living with serious chronic pain or coping with pain at the end of life. They too face significant challenges. So, as we consider new policy steps to address the opioid addiction crisis, the FDA remains focused on striking the right balance between reducing the rate of new addiction by decreasing exposure to opioids and rationalizing prescribing, while still enabling appropriate access to those patients who have legitimate medical need for these medicines." Today, The FDA will hold a Patient-Focused Drug Development meeting to gather additional viewpoints. (FDA.gov)

Private Sector

  • Over the weekend the President and CEO of Blue Cross Blue Shield Association Scott Serota released the following statement regarding Risk Adjustment Payment Freeze: “We are extremely disappointed that the administration has frozen payment transfers under the Affordable Care Act’s (ACA) risk adjustment program, which is designed to keep costs down for consumers while meeting the medical needs of those requiring significant care. Risk adjustment is a Congressionally-mandated program that supports both the individual and small group health insurance markets. Without a quick resolution to this matter, this action will significantly increase 2019 premiums for millions of individuals and small business owners and could result in far fewer health plan choices. It will undermine Americans’ access to affordable coverage, particularly for those who need medical care the most.” (BCBS.com)

#Litigation #Legislation #Regulation #PrivateSector


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