Government News of the Week
Medicare Compliance, HIPAA, Medicare Advantage and Part D,
Health Care Reform, and Other Federal and State Government Developments
Government News of the Week is a weekly email newsletter with timely news stories from Washington, D.C., and the 50 state capitals. Articles are selected for their impact on hospitals, health plans, medical group practices, physicians and other health care providers. Subscribe now to get an issue delivered to your inbox every Monday!

February 8, 2016

You must be a registered user on to access the stories below. If you haven't yet registered, please take a minute to register now, and get access to thousands of articles, blogs and more.

(1) In a Jan. 29 lawsuit (Case 1:16-cv-00157-RMC) filed in the federal court in Washington, D.C., UnitedHealthcare demanded that CMS policies requiring plans to return Medicare Advantage (MA) overpayments within 60 days of identifying them be struck down .... (more)

(2) The FDA on Jan. 15 issued post-market draft guidance to medical device manufacturers on cybersecurity, requiring developers to notify the agency of any potentially life-threatening vulnerabilities and recommending that companies apply critical infrastructure guidelines from the National Institute of Standards and Technology .... (more)

  From the AIS Blogs
  First Month With an HSA…My God, What Have I Done? Join the conversation at the AIS Blogs.

(3) The former owner and operator of National Care EMS, a now-defunct Houston-area ambulance provider, agreed to resolve allegations that he and the company paid kickbacks to nursing facilities and hospitals in return for access to their more lucrative Medicare and Medicaid transport referrals .... (more)

(4) Massachusetts Attorney General Maura Healey (D) on Jan. 22 wrote Gilead Sciences Inc. asking that the drugmaker reconsider its pricing strategy for hepatitis C virus (HCV) agents Harvoni and Sovaldi and said the attorney general’s office is looking into whether it constitutes “unfair trade practice” in violation of Massachusetts law .... (more)

  From Congress and the Federal Agencies

(5) Jason Furman, Ph.D., chief economic adviser for President Obama, on Feb. 3 wrote in The New England Journal of Medicine that the Obama administration would propose in its fiscal year 2017 budget an increase to the threshold for the excise tax (Cadillac tax) in locales where health care is the most costly in an effort to save the tax, which is unpopular with both political parties .... (more)

(6) Rather than simply returning documents his estranged wife — the manager of a home health center — left behind when she moved from their home, a man brought the materials containing protected health information (PHI) to the Office for Civil Rights, leading to an investigation by OCR .... (more)

(7) The Oregon Department of Consumer and Business Services, Division of Financial Regulation, on Jan. 28 said it took over supervision of Portland, Ore.-based Moda Health Plan, Inc., because of concerns over its financial survival .... (more)

(8) The Affordable Care Act gives states the option of creating a basic health program (BHP) for people who earn too much to qualify for Medicaid. Just two states — Minnesota and New York — offered a BHP for 2016, but the option appears to be popular. In January, more than 350,000 low-income New Yorkers began paying $20 a month or less for coverage through the program. More than 125,000 enrolled in Minnesota’s BHP, Kaiser Health News reported Feb. 2. The ACA allows states to install a BHP for individuals earning between 133% and 200% of the federal poverty level (FPL) who are not otherwise eligible for Medicaid, the Children’s Health Insurance Program, other government programs or employer-sponsored insurance (HEX 8/15, p. 5). While the BHP concept was outlined in the ACA, it wasn’t until February 2015 that CMS issued final guidance for the 2016 plan year .... (From Inside Health Insurance Exchanges' E-Alert)

(9) Louisiana Attorney General Jeff Landry on Jan. 26 said the state had arrested a woman for allegedly stealing information on 13,000 Medicaid beneficiaries .... (more)

(10) The House on Feb. 2 failed to override President Obama’s Jan. 8 veto of legislation that would have gutted his health reform law .... (more)

(11) An HHS administrative law judge (ALJ) ruled on Feb. 3 in favor of the Office for Civil Rights (OCR) and upheld the $239,800 civil money penalty (CMP) imposed on Lincare, Inc., for violating the HIPAA privacy rule .... (more)

(12) As part of an ongoing investigation into sudden drug price increases, the House Committee on Oversight and Government Reform on Feb. 2 said it obtained more than 75,000 pages of documents from Valeant that include emails to and from CEO Michael Pearson .... (more)

(13) Flint, Mich.-based HealthPlus and Detroit-based Health Alliance Plan (HAP) received final regulatory approval for their merger .... (more)

(14) A stolen laptop exposed more than 28,000 records at Montana-based New West Health Services .... (more)

(15) The CMS payment model for certain chronic conditions resulted in underpayments to providers in fee-for-service Medicare totaling $2.6 billion .... (more)


Content questions or suggestions should be directed to Executive Editor Jill Brown at If you are interested in advertising in GOVERNMENT NEWS OF THE WEEK please contact Bailey Sterrett at

GOVERNMENT NEWS OF THE WEEK is copyrighted and protected by federal law. The re-use of its content is restricted (see below). However, you are permitted to forward this email to as many of your friends and colleagues as you wish, or better yet have them sign up for their own copy at atlantic_subscription.cfm, where you can also sign up for AIS's Health Business Daily and Spotlight on Health Insurers.

Copyright © 2016 Atlantic Information Services, Inc. (AIS). All rights reserved. It is not permissible to include all or any portion of this content on any Web site, intranet or electronic network or in any print publication, without AIS's written permission in advance. Permission requests should be directed to

With archives of AIS's Government News of the Week, features like the News Archives, AIS Blogs and more! (Free registration required)

AISHealth  Follow AISHealth on Twitter  Follow AISHealth on Facebook  Follow AISHealth on LinkedIn




Upcoming Webinars

Intel’s Direct-to-Employee Benefit Model: A Case Study for Plans and Purchasers
Tues., Feb. 23, 2016
Click here for details

Managing High-Cost Drug Categories: Strategies for Health Plans and PBMs
Wed., Feb. 24, 2016
Click here for details

Oncology Immunotherapies: Payer Strategies to Maximize Outcomes While Containing Costs
Wed., March 2, 2016
Click here for details

CMS’s New ‘45-Day Notice’ and Draft Call Letter: Implications for MA and Part D Plan Strategies
Wed., March 16, 2016
Click here for details

Missed a Live Event?
Listen at your convenience to recent webinars with On-Demand or CD options!
Save When You Reserve AIS’s Directory of Health Plans: 2016 & Get a FREE Report!
Health Insurance Exchange Database: 2016 Plans and Premiums - Now with online access!
Medicare Advantage News