From Report on Medicare Compliance - In a new fraud alert, the HHS Office of Inspector General (OIG) lets physicians know they’re on the hook for contracts that don’t comply with fraud and abuse laws. The one-page fraud alert, released June 9, makes it clear that OIG will throw the book at the takers of payments for referrals and not just the givers, lawyers say. It’s not an academic exercise; OIG already made its move in 12 civil monetary penalty settlements last year with physicians stemming from a Department of Justice false claims settlement with a diagnostic imaging company that allegedly paid them kickbacks disguised as compensation… Read more
From Drug Benefit News - Three years after SXC Health Solutions Corp. purchased Catalyst Health Solutions, Inc. to create what it hoped would be a viable contender with major PBMs CVS/caremark and Express Scripts Holding Co., Catamaran Corp. will soon secure itself positioning as the third largest PBM when it is acquired by UnitedHealth Group and merged with its in-house PBM, OptumRx (DBN 4/3/15, p. 1). Read more
From Drug Benefit News - Before UnitedHealth Group and Catamaran Corp. on March 30 unveiled plans to combine the stand-alone PBM with the health plan operator’s OptumRx unit (DBN 4/3/15, p. 1), the PBM contemplated multiple transaction options, according to a new proxy statement filed by Catamaran. These include potential combinations with several unnamed parties, such as one that analysts believe to be Express Scripts Holding Co., which could have raised significant antitrust concerns. Read more
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