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

November 17, 2014

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(1) The Supreme Court said on Nov. 7 that it would take up King v. Burwell (14-114) during its current session in order to determine if premium subsidies awarded to 4.7 million enrollees on HealthCare.gov were illegal because the wording of the Affordable Care Act (ACA) indicates that only exchanges set up by states can issue subsidies .... (more)

(2) A set of answers to frequently asked questions (FAQ) issued on Nov. 6 by HHS and the departments of Treasury and Labor clarifies that an employer would run afoul of the Affordable Care Act (ACA) if it reimburses an employee for the purchase of an individual market plan .... (more)


  From the AIS Blogs
  Following the FDA approval of more effective treatments, Vertex Pharmaceuticals withdrew its hepatitis C drug Incivek from the U.S. market earlier this month. Do you think this was the right decision for Vertex, or should Incivek still be available as an alternative to the newer and more costly drugs? Join the conversation at the AIS Blogs.

(3) CMS is proposing that Medicare cover an annual screening for lung cancer with low dose computed tomography (LDCT) as an additional preventive service benefit .... (more)

(4) CareAll Management LLC and its affiliates agreed to pay $25 million to settle false claims allegations in a home health care case .... (more)


  From Congress and the Federal Agencies
 

(5) The Obama administration is predicting far fewer people will enroll in coverage through a public insurance exchange for 2015 .... (more)

(6) A new Government Accountability Office (GAO) report (GAO-15-58) released on Nov. 13 said the health reform law’s exchanges for small businesses are failing to attract interest, echoing what health insurance industry stakeholders have been saying for months .... (more)

(7) Queen’s Medical Center in Honolulu was overpaid $318,587 after making mistakes on 49 of 223 claims audited .... (more)

(8) Cigna Corp. agreed to cap costs for Florida members using HIV/AIDS prescription drugs .... (more)

(9) The cost of operating the call center for Colorado’s state-run insurance exchange is expected to jump by $4 million .... (more)

(10) Hospitals were overpaid for replaced cardiac devices by two Medicare administrative contractors (MACs), which had sequential responsibility for jurisdiction 15 (Kentucky, Ohio and West Virginia) .... (more)

(11) Premiums for Covered California’s Small Business Health Options Program (SHOP) should increase by 5.2% on a statewide weighted average basis for the 2015 plan year .... (more)

 

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