(Reuters)—The U.S. Justice Department (DOJ) has accused UnitedHealth Group Inc. of obtaining inflated payments from the government based on inaccurate information about the health status of patients enrolled in its largest Medicare Advantage Plan.1 The complaint, filed in federal court in Los Angeles on Monday, came after the DOJ earlier this year intervened in two…
How to Bill Medicare Patients for Non-Covered Services
What do you do when you are presented with a patient who needs treatment but the patient’s insurance company will not pay for the services? Can you provide the services anyway? Who will pay for them? How do you collect payment for such services? If the patient consents to receive the services in spite of…
Maryland Lawmakers Approve Bill to Fight Drug Price-Gouging
WASHINGTON (Reuters)—Maryland lawmakers have passed a first-in-the-nation measure that lets the state attorney general sue generic drugmakers that sharply raise prices in a move aimed at fighting what legislators call “price-gouging.” The bill overwhelmingly was approved by the Democratic-controlled legislature on Monday and hailed by Maryland Attorney General Brian Frosh as a way to check…
Trump Appears to Be Losing Battle Ahead of Healthcare Vote
WASHINGTON (Reuters)—U.S. President Donald Trump and Republican congressional leaders appeared on Wednesday to be losing the battle to get enough support in the House of Representatives to pass their Obamacare rollback bill, watched by wary investors in financial markets. The current House Republican rollback plan is scheduled for a floor vote on Thursday but faces…
UnitedHealth Sued by U.S. Over Medicare Charges
(Reuters) – The U.S. Department of Justice (DOJ) has joined a whistleblower lawsuit against UnitedHealth Group Inc. that claims the country’s largest health insurer and its units and affiliates overcharged Medicare hundreds of millions of dollars, a law firm representing the whistleblower said on Thursday. “We reject these more than five-year-old claims and will contest…
U.S. Court Blocks Anthem-Cigna Deal
(Reuters)—A federal judge on Wednesday ruled against U.S. health insurer Anthem Inc.’s proposed $54 billion merger with smaller rival Cigna Corp, derailing an unprecedented effort to consolidate the country’s health insurance industry. The U.S. Department of Justice sued in July to stop Anthem’s purchase of Cigna, a deal that would have created the largest U.S….
Stronger Malpractice Laws May Not Prevent Surgical Complications
(Reuters Health)—More aggressive malpractice climates don’t necessarily protect patients from surgical complications, a new study suggests. Supporters of medical malpractice laws that make it easier for patients to sue doctors say these protections are necessary to improve care. But in the current study, the risk of litigation didn’t translate into better outcomes, said study leader…
U.S. Supreme Court to Hear Dispute Over Biologic Drug Sales
NEW YORK (Reuters)—The U.S. Supreme Court on Friday agreed to hear a dispute over whether companies that make copycat versions of biologic drugs must wait six months after winning federal approval to begin selling them. The justices will take up an appeal by Novartis AG of a 2015 federal appeals court decision that prevented the…
Verdict: Johnson & Johnson to Pay More Than $1 Billion for Defective Hip Implants
(Reuters)—A federal jury in Dallas on Thursday ordered Johnson & Johnson (J&J) and its DePuy Orthopaedics unit to pay more than $1 billion to six plaintiffs who said they were injured by Pinnacle hip implants. The jurors found that the metal-on-metal Pinnacle hip implants were defectively designed and that the companies failed to warn consumers…
Senator Warns Against Simultaneous Overhaul of Medicare & Obamacare
WASHINGTON (Reuters)—A senior U.S. Senator warned his on Thursday against simultaneously overhauling Medicare and the Obamacare health insurance program, saying this would be “biting off more than you can chew.” The cautionary comments from Sen. Lamar Alexander (R-Tenn.) came after House Speaker Paul Ryan, long an advocate of privatizing Medicare, said Republican lawmakers would be…
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