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

December 15, 2014

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(1) The Vermont Department of Financial Regulation (DFR) on Dec. 3 said Cigna Corp.’s Cigna Behavioral Health Inc. unit agreed to pay nearly $400,000 to the state to settle charges that it used unlicensed mental health review agents to evaluate and allocate patient care .... (more)

(2) North Dakota Insurance Commissioner Adam Hamm (R) fined Blue Cross Blue Shield of North Dakota $60,000 for failing to comply with several state and federal regulations .... (more)

(3) On Dec. 5, U.S. Magistrate Judge Michael Watanabe in Colorado ordered Aetna Inc. and two of its subsidiaries involved in a patent case (HealthTrio v. Aetna, Civil Action No. 12-cv-03229-REB-MJW) to turn over more documentation and drop its “absurd” withholding of evidence .... (more)

(4) The state Supreme Court of Connecticut has ruled that a patient may sue a provider for negligence using HIPAA as the standard of care .... (more)


  From Congress and the Federal Agencies
 

(5) In a Nov. 21 request for comments on enhancements being considered for the star quality ratings program for 2016 and beyond, CMS reiterated several previously planned changes that could impact Medicare Part D plans and floated a few new proposals .... (more)

(6) OtisMed Corp. and its former Chief Executive Officer Charlie Chi pleaded guilty to charges related to the distribution of FDA-rejected knee replacement surgery cutting guides .... (more)

(7) The HHS Office of Inspector General issued its semiannual report to Congress on Dec. 10. The report summarizes the office’s achievements during the second half of fiscal year 2014, which ended Sept. 30 .... (more)

(8) Ear Nose and Throat Associates of Corpus Christi, LLC, agreed to pay $200,630 to resolve allegations it violated the civil monetary penalty law .... (more)

(9) Illinois lawmakers on Dec. 3 did not act on a proposal to turn the state’s public exchange into a state-run exchange from its current status as a federally facilitated marketplace .... (more)

(10) The CMS Office of the Actuary on Dec. 2 notified Medicare insurers that its preliminary projections for the growth of the United States Per Capita Cost for 2016 — which is used in determining the Medicare Advantage payment change for that year — are 2.02% and 2.45% for the two relevant measures .... (more)

(11) Beth Israel Deaconess Medical Center in Boston will pay $100,000 over the 2012 theft of a laptop with the unencrypted data of about 4,000 patients and employees .... (more)

(12) A provision in new legislation introduced by U.S. House Ways and Means Health Subcommittee Chairman Kevin Brady (R-Texas) and Ranking Member Jim McDermott (D-Wash.) seeks to establish a drug management program for Medicare Part D beneficiaries who are at risk of prescription drug abuse .... (more)

(13) Eleven people were charged in a $25 million Medicare and Medicaid fraud scheme in South Florida .... (more)

(14) A laptop and cell phone containing the PHI of 999 patients of Brigham and Women’s Hospital in Boston were stolen in an armed robbery .... (more)

 

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