Government News of the Week
Medicare Compliance, HIPAA, Medicare Advantage and Part D,
Health Care Reform, and Other Federal and State Government Developments

November 24, 2014

Note: Government News of the Week will not be published next week. The next issue will be sent on Dec. 8.

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(1) A group of Republican senators petitioned HHS Sec. Sylvia Burwell in a Nov. 18 letter to recover federal funds spent on failed state health insurance exchanges .... (more)

(2) A proposed “mega-reg” that would have addressed certain inconsistencies in the 340B Drug Pricing Program has been withdrawn from consideration by the Office of Management and Budget (OMB) .... (more)

  From the AIS Blogs
  The Medicare Payment Advisory Commission may not be as influential these days as its creators envisioned, especially since the Congress it advises doesn’t even listen to its own members, let alone an outside body...What do you think about MedPAC’s new role — or non-role — in helping Congress make decisions on MA? Can this oasis of both civility and knowledge in increasingly poisonous and polarized Washington have some influence on MA, or are its MA sessions just a nice way to break up a long workday? Join the conversation at the AIS Blogs.

(3) The Department of Justice collected $24.7 billion in civil and criminal actions in fiscal year 2014, which ended Sept. 30 .... (more)

(4) A new lawsuit filed by three pharmacies alleges that Express Scripts Holding Co. is violating federal law by blocking claims for compound medications .... (more)

  From Congress and the Federal Agencies

(5) A five-month investigation by California’s Dept. of Managed Health Care (DMHC) determined that Blue Shield of California and WellPoint, Inc. subsidiary Anthem Blue Cross violated state law and exaggerated the number of network doctors available through the plans they sold via the Covered California insurance exchange .... (more)

(6) Rep. Kevin Brady (R-Tex.), chairman of the House Ways and Means Subcommittee on Health, on Nov. 19 unveiled a “discussion draft” of legislation to reform Medicare Part A hospital payments and improve the recovery audit contractor (RAC) program .... (more)

(7) New Hampshire canceled its April 1, 2015, deadline for the planned Medicaid managed care transition for nursing homes and community organizations caring for senior citizens .... (more)

(8) CMS needs to improve cost and quality transparency for Medicare and Medicaid beneficiaries, a Nov. 18 report from the Government Accountability Office (GAO) said after the government watchdog compared two private transparency tools to CMS’s website .... (more)

(9) The former chief operating officer of Hollywood Pavilion LLC, a Miami-area hospital, pleaded guilty on Nov. 18 for his role in a mental health care fraud scheme .... (more)


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