The ABCs of MACRA The transition year under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is at an end. MACRA repealed the Medicare Sustainable Growth Rate (SGR) methodology for updates to the Physician Fee Schedule (PFS) and replaced it with a value-driven payment system. The new approach to payment is called the…
BOSTON (Reuters)—United Therapeutics Corp will pay $210 million to resolve U.S. claims that the drugmaker used a charity as a conduit to illegally cover Medicare patients’ out-of-pocket drug costs in order to eliminate price sensitivity and to boost sales. The U.S. Attorney’s Office in Massachusetts on Wednesday announced the settlement, one of the first to…
(Reuters)—A U.S. trade association representing medical laboratories filed a lawsuit on Monday challenging a new reimbursement system used by the federal government that it said would reduce how much Medicare pays for labs by about $670 million in 2018. The American Clinical Laboratory Association (ACLA) in a lawsuit in federal court in Washington, D.C., said…
(Reuters)—U.S. drugstore chain operator CVS Health Corp said on Sunday it had agreed to acquire U.S. health insurer Aetna Inc. for $69 billion, seeking to tackle soaring healthcare spending through lower-cost medical services in pharmacies. This year’s largest corporate acquisition will combine one of the nation’s largest pharmacy benefits managers (PBMs) and pharmacy operators with…
Every day, more than 5 million records are lost or stolen. That’s more than 217,000 records per hour, 3,600 records per minute and 60 records every second. Due to increasingly sophisticated hacking tactics and ransomware, it’s anticipated that the number of reported breaches will continue to rise at an accelerated rate. In August, the list…
(Reuters)—Kentucky accused units of Endo International Plc. on Monday of contributing to drug overdoses by deceptively marketing its painkiller Opana ER, in the latest lawsuit by state or local governments against the drugmaker amid an opioid epidemic. Kentucky Attorney General Steve Beshear said the lawsuit would seek to hold Endo responsible for illegally building a…
(Reuters)—A U.S. House of Representatives subcommittee on Thursday called a November 7 hearing on the legitimacy of an agreement between drugmaker Allergan Plc and a Native American tribe intended to shield patents from administrative review. The House Judiciary Committee’s subcommittee on intellectual property, chaired by Republican Representative Darrell Issa of California, said in a statement…
(Reuters)—New Jersey on Tuesday sued Purdue Pharma LP, accusing the OxyContin maker of contributing to the state’s opioid crisis through deceptive marketing to doctors and patients, including the elderly and the “opioid-naive.” Christopher Porrino, the New Jersey attorney general, faulted what he called a decade-long marketing campaign of “almost inconceivable callousness and irresponsibility, and said…
BOSTON (Reuters)—The billionaire founder of Insys Therapeutics Inc was arrested on Thursday on U.S. charges he participated in a scheme to bribe doctors to prescribe a fentanyl-based cancer pain drug, marking a step by authorities to fight the opioid epidemic. John Kapoor, Insys’ majority shareholder who stepped down as chief executive in January, was charged…
BOSTON (Reuters)—A Rhode Island doctor pleaded guilty on Wednesday to charges he participated in a scheme to obtain kickbacks in exchange for writing prescriptions for an addictive fentanyl-based cancer pain drug produced by Insys Therapeutics Inc. The plea by Jerrold Rosenberg came amid ongoing investigations of Insys related to Subsys, an under-the-tongue spray that contains…