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

August 11, 2014

NOTE: AIS's Government News of the Week will not be published August 18. The next issue will be August 25.

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(1) The Justice Department on Aug. 1 appealed the Halbig v. Burwell ruling by the U.S. Court of Appeals for the D.C. Circuit that declared illegal the federal subsidies granted for public exchange enrollees on federally facilitated exchanges .... (more)

(2) Marking another key step in the long-awaited arrival of biosimilars to the U.S., Sandoz on July 24 said the FDA accepted biosimilar filgrastim for review .... (more)

  From the AIS Blogs
  If you can’t beat 'em, sue ’em — or discourage their beneficiaries from participating. That at least may be the attitude of some provider groups toward the Medicare-Medicaid dual eligibles demonstration programs starting up in multiple states … Is there a way for providers and plans to really work together and make these demos successful for everyone, or is that just a midsummer night’s dream? Join the conversation at the AIS Blogs.

(3) A California Superior Court judge on Aug. 1 denied a motion for a preliminary injunction filed by a provider-led group seeking to block implementation of the state’s Medicare-Medicaid dual-eligibles initiative .... (more)

(4) The Missouri Department of Insurance on Aug. 4 said two units of WellPoint’s Anthem BlueCross BlueShield of Missouri subsidiary agreed to a settlement to return $7.8 million to policyholders in the state .... (more)

  From Congress and the Federal Agencies

(5) CMS continued to think out loud about the two-midnight rule for hospital admissions, but made only one minor change to it in the 2015 final inpatient prospective payment system (IPPS) regulation .... (more)

(6) CMS extended the temporary moratoria on Medicare enrollment of new home health agencies, HHA sub-units and Part B ambulance suppliers for six months in certain locations, effective July 30 .... (more)

(7) Largely as a result of rising enrollment in initiatives for Medicare-Medicaid dual eligibles, prepaid Medicare medical plans grew by 84,000 members in the 34-day period ending June 13 .... (more)

(8) Greenwood, S.C.-based Self Regional Healthcare on July 23 said it notified HHS, state regulators and affected individuals that a laptop containing protected health information (PHI) was stolen from one of its facilities on May 25 .... (more)

(9) Florida barred Medicaid insurers in the state from marketing their plans directly to Medicaid recipients as the state completes the rollout of its expanded Medicaid managed care program to the general Medicaid population .... (more)

(10) A three-judge panel of the 3rd District Court of Appeal in Sacramento, Calif., threw out a $4 billion lawsuit against Sutter Health Foundation .... (more)

(11) A disbarred Florida attorney was sentenced to 70 months in prison in connection with a $28.3 million Medicare fraud scheme involving false claims for physical and occupational therapy .... (more)

(12) Social Security numbers of about 18,000 California doctors were accidentally released with other data by Blue Shield of California and the state Department of Managed Health Care (DMHC) .... (more)


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