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AstraZeneca Plc is in talks to settle a Texas lawsuit claiming that the company fleeced the state’s Medicaid program by fraudulently marketing one of its top drugs, according to court filings.
Texas sued the drugmaker in 2013, saying AstraZeneca had targeted the state’s Medicaid program by urging doctors to prescribe the powerful antipsychotic Seroquel for unauthorized treatments — particularly for children — over six years.
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The American Medical Association’s House of Delegates voted to adopt new policies during the national physician organization’s annual meeting this week, and in the process reaffirmed its opposition to caps on Medicaid funding, eyeing a possible healthcare overhaul by Congress and the Trump administration.
Carl A. Sirio, MD, said in a statement that capping Medicaid funding would be “disastrous” for patients because it would limit medical responses to unforeseen events and medical innovations.
read more at healthcarefinancenews.com
America’s largest chain of psychiatric hospitals is the target of a multi-agency federal investigation into whether it systematically holds patients longer than necessary to maximize revenues — an allegation two nurses at one of its facilities raised following a protest a
t its headquarters in Pennsylvania last week.
According to three sources with direct knowledge of the investigation, officials are examining whether Universal Health Services directs its hospitals to hold patients for as many days as their insurer agrees to pay for, regardless of actual medical need. The probe has been ongoing since at least 2013, when the Department of Health and Human Services issued subpoenas to 10 UHS psychiatric hospitals.
But BuzzFeed News has exclusively learned that the investigation has since broadened to include the FBI and the Department of Defense, which is scrutinizing UHS’s billings to Tricare, the insurance plan for active military and their families. UHS, a $12 billion company, made nearly one-third of its revenues last year from government insurance providers such as Medicare and Medicaid.
Read more at buzzfeed.com
Many are still unhappy with Obamacare.
The main intent of the Affordable Care Act was to expand the safety net (Medicaid), regulate the non- employer-based private insurance market (the insurance exchanges) and help people buy that insurance (subsidies) in order to reduce the number of Americans who are uninsured.
On those metrics, it appears to be succeeding.
First and foremost, Obamacare was about improving access to healthcare. While it did improve access to insurance, in many, many other ways the United States is falling short. Things are likely to get worse before they get better.
Even with Obamacare, the Unites States still ranks poorly among comparable countries in insurance coverage. Even in 2016, when the rate of insured is the best it has ever been in the United States, Americans still have a greater percent of the population uninsured than pretty much any other industrialized nation in the world.
A Grinnell, Iowa physician has pleaded guilty in federal court on two counts of health care fraud, says U.S. Attorney Kevin VanderSchel .
Richard Hauser, 66, of North Liberty, submitted claims to Iowa Medicaid and Wellmark Blue Cross Blue Shield for a more expensive service than was actually performed in order to receive a profit, according to the plea agreement. Hauser “up coded” these services from November 2011 through December 2012 while working at a clinic in Grinnell called The Hauser Clinic.
Source: http://wqad.com/2016/10/19/former-iowa-psychiatrist-pleads-guilty-to-health-care-fraud/