Industry News
News for Insurers
Top stories summarized by our editors
6/18/2021

Seven Texas residents are facing multiple charges, including health care fraud, conspiracy to pay and receive illegal kickbacks and conspiracy to commit money laundering. Authorities said the defendants engaged in a more than $110 million health care fraud and kickback scheme involving compound drugs.

Full Story:
Department of Justice
6/18/2021

The Supreme Court dismissed a challenge to the Affordable Care Act Thursday, and AHIP applauded the decision, which argued that the states and individual plaintiffs in the case did not have legal standing to bring the challenge. "This decision protects the stability of health coverage for people with pre-existing conditions, hardworking families, seniors, and other Americans who need it most," said AHIP President and CEO Matt Eyles.

6/18/2021

An analysis of US government data showed orthopedic surgeons received more than $3.1 billion from makers of hardware for artificial knees, hip joints and spinal implants from August 2013 through 2019, and they account for 25% of physicians who have accepted at least $100,000 and two-thirds of those who accepted at least $1 million from manufacturers last year. Most of the money was considered payment for medical research, consulting duties or royalties, but federal investigators and industry whistleblowers say payments can affect medical judgment and lead to unnecessary and potentially harmful care.

Full Story:
Kaiser Health News
6/18/2021

The US recorded more than 2.5 million cases of syphilis, chlamydia and gonorrhea in 2019, marking the sixth consecutive year of record increase in sexually transmitted diseases, and rates were higher among Hispanic and Latino, Black, and Native American, Alaska Native and Pacific Islander populations than among white populations. Disease burden varies by state, with Alaska and Mississippi leading for chlamydia and gonorrhea, and Nevada and New Mexico leading for syphilis.

Full Story:
USA Today
6/18/2021

Anthem Blue Cross Blue Shield and drugmaker Catalent have joined CivicaScript, a unit of Civica Rx, which aims to produce lower-cost generic drugs for retail pharmacies. Civica officials said they plan to produce as many as 10 common generic drugs that lack competition, and they expect to launch their first drug next year.

Full Story:
Axios
6/18/2021

Sen. Joe Manchin, D-W.Va., urged President Joe Biden to nominate a permanent commissioner to lead the FDA after the agency's controversial decision to approve the Alzheimer's drug Aduhelm. The drug was approved over objections from an FDA advisory panel, and Manchin noted permanent leadership is needed to oversee applications for full approval of COVID-19 vaccines and a resurgence of the opioid epidemic.

Full Story:
The Hill
6/18/2021

The Biden administration will invest over $3 billion to develop and manufacture antiviral medications for COVID-19 as part of the Antiviral Program for Pandemics initiative, a collaboration among the NIH, the National Institutes of Allergy and Infectious Diseases and the Biomedical Advancement Research and Development Authority. "An easily administered oral antiviral drug would be an important part of our therapeutic arsenal that would complement the great success of our vaccine efforts," said Dr. David Kessler, chief science officer for the administration's pandemic response team.

6/18/2021

Danaher, a medical equipment maker, will acquire Aldevron in a $9.6 billion all-cash deal. Aldevron, a producer of mRNA and proteins, is a supplier of plasmid DNA for Moderna's COVID-19 mRNA vaccine.

Full Story:
Reuters
6/18/2021

Colorado Gov. Jared Polis on Wednesday signed HB21-1232, originally intended to be a state public option bill, which requires insurers to collaborate with the state and health care providers to create a lower-cost health insurance plan with coverage for essential benefits by Jan. 1, 2022, according to The Denver Post. Gov. Polis also signed into law SB21-175, which calls for creating a Prescription Drug Affordability Review Board that would evaluate drug costs and could set new drug price limits.

6/18/2021

Pennsylvania residents Zhanna Sainz and Mikhail Bagdasarian were charged with four counts of Medicaid fraud and one count of theft by deception. Authorities said the defendants collected more than $95,000 by submitting false timesheets related to in-home care for Sainz's elderly mother.

Full Story:
WPMT-TV (York, Pa.)