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!

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)

  From the AIS Blogs
  The same day that a Maryland federal judge dismissed a putative class action against CareFirst for the 1.1 million record data breach the insurer revealed last May, a California federal judge approved another one against Anthem for the massive breach it revealed last February exposing the records of approximately 80 million people. With as many as one in four Americans affected by data breaches, the courtroom debate will keep evolving, but will more judges dismiss or approve claims? Join the conversation at the AIS Blogs.

(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)

  From Congress and the Federal Agencies

(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(6) The FDA tweaked its April 4 draft guidance on biosimilar labeling and extended the comment period to Aug. 2 ....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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