Michael Kappel

Report: Obamacare Replacement Will Likely Cover Fewer Americans

So far, the only thing the White House has said about its plans to replace the Affordable Care Act is that it would provide “insurance for everyone” and that people would be “beautifully covered,” but comments coming out of Washington indicate that not everyone will be able to obtain coverage under the replacement plan. [More]

House ‘Freedom Caucus’ Asks Trump To Undo 232 Rules On Net Neutrality, Tobacco, Nursing Homes & Ceiling Fans

What’s on your wish list this holiday season? For the few dozen members of the House of Representatives Freedom Caucus, the hope to see President-elect Donald Trump undo or revise more than 200 federal rules involving everything from tobacco to food labels to ceiling fans to your constitutional right to bring a lawsuit against your credit card company. [More]


States That Expanded Medicaid Hope To Keep It Under Trump Administration

There’s no way to tap-dance around this one: healthcare access is an incredibly politicized and partisan issue in this country. And yet even while our two major political parties disagree vehemently, at every level, about whether existing healthcare laws are effective or worthwhile, at least one part now proving popular in a surprisingly bipartisan way. [More]

Phillip Bradshaw

Earlier this month, drugmaker Mylan disclosed a $465 million settlement with the U.S. Department of Justice over allegations that the company had defrauded the Medicaid system by mis-categorizing its high-priced EpiPen allergy treatment. The DOJ has still yet to confirm this settlement or provide any details, and critics of the deal say it looks like Mylan is getting off easy. [More]

Nursing Home Industry Files Lawsuit To Keep Preventing Patients From Filing Lawsuits

Last month, the federal government issued new rules for nursing homes, barring most long-term care facilities from using forced arbitration agreements to stop new residents from filing lawsuits against the homes. Now nursing home operators and industry trade groups are challenging that rule by doing the one thing they want to prevent their patients from doing: going to court. [More]


Mylan To Pay $465M To Settle EpiPen Medicaid Pricing Scandal; Critics Call Deal “Inadequate”

Amid recent revelations that EpiPen maker Mylan has been overcharging U.S. taxpayers for potentially hundreds of millions of dollars since at least 2011, the drug company says it has agreed to pay $465 million to close the book on a federal investigation into its Medicaid pricing — all without admitting any liability. [More]

Phillip Bradshaw

Administrator: Mylan Has Overcharged Medicaid For EpiPen By At Least 10%

Though the EpiPen emergency allergy treatment has been around for decades, the increased demand for the drug and its soaring price tag have caused Medicaid spending on EpiPen to go from around $66 million in 2011 to $365 million in 2015. All this time, claims Andrew Slavitt, Acting Administrator for the Center for Medicare & Medicaid Services, Mylan’s parent company has been shortchanging Medicaid on rebates. [More]


As we’ve written about previously, some nursing homes and other long-term care facilities use forced arbitration contracts to prevent their residents bringing a legal action against the home in a court of law. Today, the Department of Health and Human Services issued a new rule that will prohibit long-term care facilities that accept Medicare or Medicaid from forcing residents into arbitration. [More]


Feds Impose Sanctions On Blood-Testing Startup Theranos And Its Founder

Lab testing startup Theranos started from a revolutionary idea: performing blood tests quickly and inexpensively using only a drop of blood. The idea may have been more revolutionary if the technology actually worked yet, and if its lab in California had been operating up to current standards. Now the federal government has imposed sanctions on the company, which include being unable to bill Medicare or Medicaid for its services, and its founder and CEO can’t own or run a laboratory for the next two years. [More]

California Accused Of Allowing Nursing Homes To Permanently “Dump” Elderly Patients On Hospitals

California Accused Of Allowing Nursing Homes To Permanently “Dump” Elderly Patients On Hospitals

A new lawsuit accuses the California Department of Health and Human Services of deliberately turning a blind eye to the illegal practice of taking nursing home residents who receive state aid and “dumping” them into the hospital system by refusing to let them return, even under binding orders to readmit them. [More]

Merck disclosed this week that federal prosecutors have requested information on its pricing of prescription asthma medication Dulera.

Big Pharma Companies Also Being Questioned About Drug Prices

Earlier this week, we told you how a Senate committee was investigating huge price hikes on a handful of niche-market prescription drugs. The companies involved in those probes are generally newer, smaller operations — but it looks like two much bigger names in the pharmaceuticals industry are also being asked about the prices of their drugs. [More]

Once Medicaid Decides That You’re Dead, It’s Hard To Come Back To Life

Once Medicaid Decides That You’re Dead, It’s Hard To Come Back To Life

When you’re dead, you generally can’t come back. It’s also difficult to come back when you’re actually alive, but the government thinks that you’re dead. An 87-year-old on Brooklyn is understandably worried, because Medicaid has declared her dead. If other government services believe them, dead people don’t need to do things like visit doctors or eat, so her income, food stamps, and health insurance would stop. This would be bad. [More]

(Curtis Perry)

Kmart Pays $1.4 Million To Settle Accusations Of Illegal Coupon Acceptance, Prescription Incentives

In most of the country, pharmacies can offer rewards points, coupons, or other inducements to get you to switch prescriptions to them. Not only is this illegal in certain states, it’s also illegal to offer these incentives to customers with health insurance through Medicaid. Kmart has settled allegations from a whistleblower that it did exactly that for customers with Medicaid, and accepted co-pay coupons for brand-name drugs for them. [More]

Anthem Hack Included Personal Information For 78.8 Million Customers & Employees

Anthem Hack Included Personal Information For 78.8 Million Customers & Employees

Nearly three weeks removed from the detection of a massive data breach, health insurer Anthem Inc. is releasing more details about the scope of the hack, including the fact that personal information for about 78.8 million was compromised. [More]

Feds Investigating One Of The Nation’s Largest Assisted Living Companies

Feds Investigating One Of The Nation’s Largest Assisted Living Companies

Last summer, a ProPublica/Frontline report put a spotlight on Emeritus Senior Living, one of the country’s largest private operators of assisted living facilities (and soon to be the largest, if a proposed merger goes through), raising questions about the company’s business practices and the general lack of regulation in the industry. Now comes news that Emeritus is under investigation by the federal government. [More]

Hospital Chain Inflated Bills, Pressured Doctors Into Generating Admissions, Lawsuits Claim

Hospital Chain Inflated Bills, Pressured Doctors Into Generating Admissions, Lawsuits Claim

There are many accusations of money-grubbing in the health care industry. Most of them are subtle: a preferred medication here, a handshake behind closed doors there. But actually hanging a chart on the wall and proudly color-coding your ER doctors like car salesmen based on how high their admission rates are? That’s about as in-your-face as the pursuit of profit gets.



So The Government Is Shut Down… Do I Still Have To Pay My Taxes?

As the sun rises over Washington, D.C., this morning, huge numbers of federal employees are either not coming in to work or are only coming in to shut down their offices until lawmakers sort this mess out. But just because the wheels of government have come grinding to a halt doesn’t mean everything is put on hold indefinitely. [More]


What Today’s Supreme Court Ruling Means For Gay Couples’ Wallets

Earlier today, the Supreme Court effectively struck down the federal Defense Of Marriage Act. For same-sex couples around the country, this could open up a whole new world of tax breaks and benefits that were previously not allowed, while also taking away some unintended perks that same-sex couples had enjoyed because the government did not recognize their unions. [More]