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]
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]
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]
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]
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]
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]
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]
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]
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]
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]
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.
If you watch daytime TV or have been stuck watching daytime TV while visiting your parents, surely you’re familiar with The Scooter Store. The power wheelchair vendor has had some trouble lately, including accusations of Medicare and Medicaid fraud, a raid by the FBI, and even a lawsuit from the company’s hometown, of New Braunfels, Texas. The company laid off most of its employees, and plans to deal directly with health care providers, rather than blanketing the airwaves and selling directly to consumers.
Since we began following the stories of CVS pharmacists who appear to have been pressured into automatically refilling customers’ prescriptions, regardless of whether or not a refill has been requested, we’ve received enough e-mails from from both customers and pharmacists at a number of companies who say these are not isolated incidents. [More]
Researchers have been looking into the amount of prescriptions that go unfilled for kids on Medicaid and they’ve found some pretty startling results: Almost 17,000 or 22% of prescriptions at two clinics went unfilled. Those findings mirror other studies along the same lines for adults, which have found discrepancies from 16% to 24% of those medications never getting filled.