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

December 15, 2014

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, Today from Washington postings and more.

(1) The Vermont Department of Financial Regulation (DFR) on Dec. 3 said Cigna Corp.’s Cigna Behavioral Health Inc. unit agreed to pay nearly $400,000 to the state to settle charges that it used unlicensed mental health review agents to evaluate and allocate patient care .... (more)

(2) North Dakota Insurance Commissioner Adam Hamm (R) fined Blue Cross Blue Shield of North Dakota $60,000 for failing to comply with several state and federal regulations .... (more)

(3) On Dec. 5, U.S. Magistrate Judge Michael Watanabe in Colorado ordered Aetna Inc. and two of its subsidiaries involved in a patent case (HealthTrio v. Aetna, Civil Action No. 12-cv-03229-REB-MJW) to turn over more documentation and drop its “absurd” withholding of evidence .... (more)

(4) The state Supreme Court of Connecticut has ruled that a patient may sue a provider for negligence using HIPAA as the standard of care .... (more)

  From Congress and the Federal Agencies

(5) In a Nov. 21 request for comments on enhancements being considered for the star quality ratings program for 2016 and beyond, CMS reiterated several previously planned changes that could impact Medicare Part D plans and floated a few new proposals .... (more)

(6) OtisMed Corp. and its former Chief Executive Officer Charlie Chi pleaded guilty to charges related to the distribution of FDA-rejected knee replacement surgery cutting guides .... (more)

(7) The HHS Office of Inspector General issued its semiannual report to Congress on Dec. 10. The report summarizes the office’s achievements during the second half of fiscal year 2014, which ended Sept. 30 .... (more)

(8) Ear Nose and Throat Associates of Corpus Christi, LLC, agreed to pay $200,630 to resolve allegations it violated the civil monetary penalty law .... (more)

(9) Illinois lawmakers on Dec. 3 did not act on a proposal to turn the state’s public exchange into a state-run exchange from its current status as a federally facilitated marketplace .... (more)

(10) The CMS Office of the Actuary on Dec. 2 notified Medicare insurers that its preliminary projections for the growth of the United States Per Capita Cost for 2016 — which is used in determining the Medicare Advantage payment change for that year — are 2.02% and 2.45% for the two relevant measures .... (more)

(11) Beth Israel Deaconess Medical Center in Boston will pay $100,000 over the 2012 theft of a laptop with the unencrypted data of about 4,000 patients and employees .... (more)

(12) A provision in new legislation introduced by U.S. House Ways and Means Health Subcommittee Chairman Kevin Brady (R-Texas) and Ranking Member Jim McDermott (D-Wash.) seeks to establish a drug management program for Medicare Part D beneficiaries who are at risk of prescription drug abuse .... (more)

(13) Eleven people were charged in a $25 million Medicare and Medicaid fraud scheme in South Florida .... (more)

(14) A laptop and cell phone containing the PHI of 999 patients of Brigham and Women’s Hospital in Boston were stolen in an armed robbery .... (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 © 2014 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


Free White Papers, Studies and Surveys

Upcoming Webinars
Save $50!

Anthem’s Cancer Care Quality Program: A Blueprint to Improve Care and Reduce Costs
Tues., Jan. 13, 2015
Click here for details

Wall Street’s Forecast for Health Insurers: Picking 2015’s Winning and Losing Trends and Companies
Tues., Jan. 20, 2015
Click here for details

Narrow-Network Medicare Advantage Plans: Strategies for Insurers and Providers
Wed., Jan. 21, 2015
Click here for details

Missed a Live Event?
Listen at your convenience to recent webinars with On-Demand or CD options!
Copay Coupons for Specialty Drugs: Strategies for Health Plans and PBMs
Inside Health Insurance Exchanges
AIS's Directory of Health Plans: 2015 - Reserve Now!