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!

March 23, 2015

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(1) On March 19, Senate and House leaders in a rare bipartisan, bicameral effort introduced legislation for a so-called “doc fix,” which would replace what lawmakers called the “broken Medicare Sustainable Growth Rate (SGR) formula with an improved payment system that rewards quality, efficiency, and innovation .... (more)

(2) Anthem, Inc. has not acted quickly enough to inform all 78.8 million Americans who may have had their personal information exposed in a cyber attack first discovered in January .... (more)

  From the AIS Blogs
  If SCOTUS rules for plaintiff in King v. Burwell, what happens next? Weigh in on a few scenarios that could play out, at the AIS Blogs.

(3) Sandoz Inc., a Novartis Group company, will pay the U.S. $12.64 million for allegedly misrepresenting average sales price data to the Medicare program between January 2010 and March 2012 .... (more)

(4) Around 16.4 million people have received insurance under the Affordable Care Act (ACA) since its implementation .... (more)

  From Congress and the Federal Agencies

(5) More than $27.8 billion has been returned to Medicare since the Health Care Fraud and Abuse Control (HCFAC) program was established .... (more)

(6) New York Attorney General Eric Schneiderman (D) on March 18 said his office had reached a settlement with Rochester, N.Y.-based Excellus Blue Cross Blue Shield to enforce state mental health parity laws .... (more)

(7) The U.S. District Court for the District of New Jersey dismissed a class-action lawsuit against Medco Health Solutions, Inc. after the PBM resolved allegations that it improperly retracted payments from pharmacies .... (more)

(8) A federal jury on March 18 convicted the former CEO, COO and CFO of Sacred Heart Hospital, a defunct Chicago facility .... (more)

(9) On March 16, Minnesota’s Republican-led House committee voted to transfer its state-based insurance exchange to by 2017, the Star Tribune reported. All House Democrats voted against it. While most other state-based exchanges have smoothed out the problems that plagued them a year ago, MNsure continues to struggle. AIS reports that 60,092 people enrolled in a qualified health plan (QHP) during the official enrollment period for 2015. Nearly 40% of 2015 QHP enrollees chose a silver-level plan, and Blue Cross Blue Shield of Minnesota took 43% of the total QHP enrollment. (From Inside Health Insurance Exchanges' E-Alert)

(10) The Department of Justice said on March 19 that the owner and operator of a New Orleans-based medical clinic and an accountant pleaded guilty for their part in a $50 million Medicare fraud scheme .... (more)

(11) BioTelemetry Inc., a heart monitoring company based in Malvern, Pa., agreed to pay $6.4 million to settle false claims allegations stemming from overbilling by its subsidiary .... (more)


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