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February 8, 2016
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(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(2) The FDA on Jan. 15 issued post-market draft guidance to medical device manufacturers on cybersecurity, requiring developers to notify the agency of any potentially life-threatening vulnerabilities and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)
(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)
(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)
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