News for Insurers
Top stories summarized by our editors
3/22/2019

CVS Health asked 60 drugmakers to hold the line on price increases in anticipation of changes to federal rules.

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Axios
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CVS Health
3/22/2019

A survey of 400 government employees showed 47% liked automatic enrollment in defined contribution plans and 77% said if they were automatically enrolled, they would stick with the plan. The survey from the Center for State and Local Government Excellence, ICMA-RC and Greenwald & Associates found 44% supported having an employer set a default deferral rate.

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PlanSponsor
3/22/2019

Virginia Gov. Ralph Northam signed legislation removing the age cap for autism coverage, which currently is limited to patients ages 2 to 10. The law takes effect next January.

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Gov. Ralph Northam, Virginia
3/22/2019

Beto O'Rourke carved out his own health care policy space as he campaigned in Iowa for the Democratic nomination to run for president. O'Rourke backed away from supporting a single-payer system and talked up the "Medicare for America" bill introduced in the House that would open up Medicare to all adults and children and automatically enroll newborns, the elderly and the uninsured.

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Slate
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Beto O'Rourke, Medicare
3/22/2019

Maryland-based MedStar Health, along with two of its hospitals in the Baltimore area, agreed to a $35 million settlement to resolve accusations that the hospital system violated the False Claims Act by paying illegal kickbacks to cardiology group MidAtlantic Cardiovascular Associates in exchange for referrals for profitable procedures between Jan. 1, 2006, and July 31, 2011. The deal also settles accusations that MedStar received improper payments from Medicare for medically unnecessary stent procedures performed from Jan. 1, 2006, to Dec. 28, 2012.

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The Baltimore Sun
3/22/2019

John Marsh, an optician from the Atlanta area and former operator of Magazine Medical Group & Associates in New Orleans, could face up to 15 years in prison after being charged with identity theft in relation to the submission of false claims to health care benefit programs. Authorities accused Marsh of using another doctor's National Provider Identifier to submit reimbursement claims for medical services.

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Department of Justice
3/22/2019

Dane Arredondo, a former paramedic at the Oglala Sioux Tribe's ambulance service in South Dakota, entered a not guilty plea to charges of acquiring controlled substances by fraud, health care fraud and possessing controlled substances. Arredondo is accused of falsely reporting discarded medications and stealing fentanyl, ketamine and midazolam from the service for his own use in January, court records show.

3/22/2019

Kimberly Hall of Bluefield, W.Va., could be sentenced to as many as five years in prison after pleading guilty to defrauding the Social Security Administration. Authorities said Hall lied to the SSA about her living arrangements with a minor, allowing her to fraudulently collect more than $50,000 in disability benefits from August 2011 to September 2016.

3/21/2019

Adults who drank more than two large cups of tea daily at temperatures higher than 140 degrees Fahrenheit were 90% more likely to develop esophageal cancer than those who consumed less tea at lower temperatures, researchers reported in the International Journal of Cancer. The findings were based on data involving 50,045 individuals ages 40 to 75 in Iran.

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CNN
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esophageal cancer
3/21/2019

A study in Health Services Research found a strong link between social determinants of health and high rates of readmission to safety-net hospitals, which often serve the most vulnerable patients. The study suggests that if the CMS were to adjust for social health factors such as disability and housing instability in hospital readmission rates, safety-net hospitals would see lower penalties under Medicare's Hospital Readmissions Reduction Program, resulting in $17 million in savings for these hospitals.

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RevCycle Intelligence
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Health Services Research