The Daily Scan

July 18, 2018

Last Updated: 8:40 AM EST

 

Litigation 

  • Frank Jaramillo and Ruth Jaramillo, owners of Healthquest, Inc. have agreed to pay $1.5 million to the United States to settle allegations that Healthquest paid kickbacks to marketers in order to induce patient referrals. The defendant will enter into a five-year Integrity Agreement with the Department of Health and Human Services, and as commented by the OIG includes, among other things, an Arrangements Review including a systems review and a transaction review to be conducted by an Independent Review Organization. (Justice.gov)

 

  • The American Hospital Association is expected to refile promptly in district court after a federal appeals court ruling yesterday. Their case was dismissed for lack of presentment after challenging a nearly 30% Medicare payment reduction for many hospitals in the 340B drug savings program. The AHA commented, "We are deeply disappointed that the courts have once again failed to rule on the merits of our case. As today’s decision stated, ‘The question presented is not whether they may obtain judicial review of their challenges….but when and how they may do so through the special-review scheme for Medicare claims.’” All groups filing the lawsuit including the AHA, Association of American Medical Colleges and America's Essential Hospitals commented “We will continue our fight to reverse these unwarranted cuts and protect access for patients.” (AHA.org

Medicare

  • A study by the GAO showed that some of CMS's fraud risk management practices aligned with leading practices, while others could be improved. Medicare improper payments were estimated to be about $52 billion in fiscal year 2017 ensuring that improvements must be made to better manage fraud risks. The GAO recommended improving fraud awareness training, conducting risk assessments, and creating an antifraud strategy. The GAO will monitor the status of CMS implementation of these risks. (GAO.gov)

Regulation

  • One of HHS’s top priorities is the implementation of a comprehensive national opioid strategy. The HHS five-point opioid strategy emphasizes the need to empower local communities to assess and respond to local needs, including both drivers and consequences of the opioid crisis. Some communities that have been affected most by the opioid crisis have also seen associated increases in Hepatitis B & C, along with other infections. The HHS has incorporated a National Academies' workshop highlighting the important of addressing infectious diseases as part of an improved, comprehensive opioid response. (HHS.gov)

Research

  • The Agency for Healthcare Research and Quality has decided to shut down the National Guidelines Clearinghouse. The American Hospital Association has asked for AHRQ to reconsider the shutdown and commented "It provides easy access to evidence-based guidelines for practice, helping busy clinicians develop plans of care for patients, allowing health care organizations to create standard protocols for practice, embed decision support for their clinicians, and reduce practice variation to ensure the best outcomes for their patients. It is regrettable that budget cuts have forced AHRQ to make the difficult decision to eliminate this valuable resource, much to the detriment of patients and the providers who treat them. We urge you to reconsider this decision." (AHA.org)

 

 

 

 

 

 

 

 

 

 

 

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