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June 20, 2016
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(1) A hospital-focused bill approved by the House on June 7 seeks to delay CMS’s authority to terminate the contracts of MA plans for low star quality ratings .... (more)
(2) Sea View Health Care Services, Inc., a for-profit home health agency (HHA) on the island of St. Thomas in the U.S. Virgin Islands, was overpaid $184,000 over two years .... (more)
(3) Although California Insurance Commissioner Dave Jones (D) has no authority to approve or deny Anthem, Inc.’s proposed acquisition of Cigna Corp., that didn’t stop him from lambasting the deal in a June 16 letter to the Dept. of Justice (DOJ) urging a federal rejection .... (more)
(4) The Medicare Payment Advisory Commission’s final report to Congress, released June 15, retains many of the significant Part D reforms MedPAC proposed in April, such as slashing the reinsurance subsidy from 80% to 20% while maintaining Medicare’s overall 74.5% subsidy of basic benefits and excluding manufacturer discounts in the coverage gap from enrollees’ true out-of-pocket costs .... (more)
(5) A salesman and a district manager for a pharmaceutical company were charged with violating the anti-kickback law in connection with payments to physicians for participating in a speaker’s bureau .... (more)
(6) The FDA tweaked its April 4 draft guidance on biosimilar labeling and extended the comment period to Aug. 2 .... (more)
(7) Maryland’s Consumer Operated and Oriented Plan (CO-OP), Evergreen Health, on June 13 filed a lawsuit in the U.S. District Court of Maryland against the Obama administration over the Affordable Care Act’s (ACA) risk adjustment program .... (more)
(8) In a shocking reversal of fortune, a judge has thrown out a $200 million jury award on a patent case involving the hepatitis C drug sofosbuvir because of “a pervasive pattern of misconduct.” .... (more)
(9) The owner of Alpha Diagnostics Services Inc., in Owings Mills, Md., was sentenced to 10 years in prison in connection with a radiology scheme that resulted in the deaths of two patients .... (more)
(10) The Indiana Dept. of Administration on June 10 unveiled its intent to award Medicaid managed care contracts to four out of the five insurers that responded to a request for proposals, rejecting a bid from UnitedHealthcare unit UnitedHealthcare Community Plan .... (more)
(11) Genentech Inc. and OSI Pharmaceuticals LLC agreed to pay $67 million to resolve False Claims Act allegations about statements regarding the effectiveness of cancer drug Tarceva (erlotinib) .... (more)
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