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!

October 24, 2016

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(1) Anthem, Inc. and Cigna Corp. must turn over documents the Dept. of Justice wants to bolster its argument that a combined Anthem-Cigna would not achieve promised efficiencies because the two companies are at odds .... (more)

(2) Mylan N.V. agreed to pay a $465 million settlement with the Department of Justice over its classification of the EpiPen (epinephrine) as a non-innovator drug under the Medicaid Drug Rebate Program (MDRP) .... (more)

  From the AIS Blogs
  Is there enough transparency in the prescription drug segment? Should consumers feel cheated out when it comes to rebates and upfront discounts? Join the conversation at the AIS Blogs.

(3) Omnicare Inc., the largest nursing home pharmacy in the country, has agreed to pay $28.125 million to settle allegations that it took kickbacks from Abbott Laboratories, a pharmaceutical manufacturer, in return for promoting the prescription drug Depakote to nursing home patients .... (more)

(4) House Speaker Paul Ryan (R-Wis.) on Oct. 14 said House Republicans are upping the ante in the brewing battle over the Obama administration possibly settling risk-corridors lawsuits filed by health plans .... (more)

  From Congress and the Federal Agencies

(5) In a case related to meaningful use of electronic health records (EHRs), St. Joseph Health (SJH), a nonprofit integrated Catholic health care delivery system sponsored by the St. Joseph Health Ministry, has agreed to pay $2.14 million to settle potential HIPAA privacy and security violations .... (more)

(6) On Nov. 1, Washington state’s insurance exchange will open two full-service health insurance enrollment centers. The retail locations in Spokane and Vancouver will offer in-person assistance to residents and help them enroll in health coverage through Washington Healthplanfinder, a state-based exchange. Spokane and Vancouver are in counties that have the highest concentrations of uninsured residents. Both storefronts will be staffed with navigators and brokers who can guide customers through the coverage options available and help determine if they qualify for financial assistance. Computer work stations also will be available .... (From Inside Health Insurance Exchanges' E-Alert)

(7) HHS Sec. Sylvia Burwell on Oct. 19 said 13.8 million individuals are expected to sign up for ACA public exchange coverage during the open enrollment period that starts on Nov. 1 for the 2017 plan year .... (more)

(8) The California Public Employees’ Retirement System (CalPERS) spent 30% more for specialty drugs in 2015 than it did the previous year. CalPERS spent $2.10 billion last year on prescription medications, up from $1.91 billion in 2014 .... (more)

(9) In a new report, the HHS Office of Inspector General (OIG) said CMS overpaid millions of dollars for chiropractic services in 2013 because most of them didn’t comply with Medicare requirements .... (more)

(10) HHS on Oct. 14 issued a final rule (CMS-5517-FC) for the Medicare Access and CHIP Reauthorization Act (MACRA), which replaces the Sustainable Growth Rate and is meant to modernize and streamline physician payments under a new quality-based system .... (more)


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