The Daily Scan

July 24, 2018

Last Updated: 8:55 AM EST 

Legislation 

  • Robert L. Wilkie, of North Carolina, to be Secretary of Veterans Affairs. This was confirmed last night by the Senate by Yea-Nay vote: 86-9. “As per CNN, during his confirmation hearing, Wilkie pledged not to privatize health care for the nation's veterans, and indicated that if confirmed he would not shy away from disagreeing with the President.” (CNN.com

Litigation 

  • First Coast Service Options, Inc., did not claim some Medicare supplemental executive retirement plan costs through its incurred cost proposals. The OIG reviewed the CYs from 2008-2010 SERP costs that FCSO claimed for Medicare reimbursement and found that ICPs, were not always correctly claimed.  The OIG recommends that FCSO works with CMS to ensure that FCSO’s final settlement of contract costs reflects an increase in Medicare SERP costs of $1.06 million for CYs 2008 through 2010. (Brief: OIG.HHS.gov, Full report: OIG.HHS.gov

 

  • United States Attorney Maria Chapa Lopez announces that Lisa McLaren pled guilty yesterday to two counts of health care fraud. McLaren Janick faces a maximum penalty of 20 years in federal prison on each count. A sentencing date has not yet been set. According to the plea agreement, McLaren Janick, while employed as a marketer for a home health agency, falsified documents relating to her husband’s Port Charlotte medical office and created bogus referrals for the patients to receive medically unnecessary home health services. Dr. Janick previously pleaded guilty in a related case to obstruction of a federal audit. His sentencing hearing is scheduled on September 11, 2018. (OIG.HHS.gov)

 

  • In a letter sent Friday from the Congressional Budget Officer Director Keith Hall, to Rep Mark Meadows (R-N.C.) the CBO vowed it would ramp up oversight of its cost-estimate process after it underestimated the impact of a Medicare Part D change made by Congress by $4 billion. Hall commented "Shortly after the Bipartisan Budget Act was enacted, CBO learned of data on prescription drug discounts in the coverage gap that had been available when the estimate was prepared but stored in an unexpected place—grouped with information about the Medicare Advantage program.3 When CBO learned of and reviewed that information, the agency determined that the data indicated a different estimate for section 53116. CBO contacted and disclosed that fact to staff of the House and Senate Committees on the Budget, the authorizing committees of jurisdiction, and leadership offices. The agency also consulted with staff of the budget committees about how to include the effects of that new information in any future estimates." (Modernhealthcare.com, Letter: CBO.gov

Regulation

  • The FDA is continuing to take key actions on bulk drug substances used for compounding to advance the regulatory goals of its 2018 Compounding Policy Priorities Plan. The FDA announced several actions to protect Public Health related to the compounding of human drug products. FDA Commissioner Scott Gottlieb, M.D. commented "Our actions underscore our focus on protecting patients while making sure we have an enduring framework for better compounding that is well informed by input from the clinical community. Our aim is to be responsive to the medical needs of patients who require compounded medicines, while making sure that these products are compounded under appropriate standards. We recognize that there continues to be great interest in our work in this important policy area and we’re committed to providing updates as we take a continuing series of actions to implement the comprehensive plan that we outlined earlier this year.” (FDA.gov)

Private Sector 

  • League, an online platform that wants to reduce the strain of managing health benefits for companies and employees announced that it has raised $62 million CAD ($47.1 million USD) Series B. League is currently one of the bigger players in the "employee wellness space" with clients like Uber, Shopify and Unilever. Michael Serbinia, League's CEO commented "I got into it naively not being a healthcare person, with not even a biology class anywhere in my past, and I very quickly realized that most people think about healthcare through the lens of health insurance, i.e. can I do it, can I afford it? The more I learned about it, the more I realized how broken it is. In the U.S. and Canada and Western European nations, healthcare gets more expensive, but you get less and less, and no one loves the experience." (Techcrunch.com

 

 

 

 

 

 

 

 

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