WASHINGTON (Reuters)—A senior U.S. Senator warned his on Thursday against simultaneously overhauling Medicare and the Obamacare health insurance program, saying this would be “biting off more than you can chew.” The cautionary comments from Sen. Lamar Alexander (R-Tenn.) came after House Speaker Paul Ryan, long an advocate of privatizing Medicare, said Republican lawmakers would be…
Employee Non-Compete Agreements in Physician Practices
You started a medical practice and, through the years, have developed policies, procedures, strategies, work products, client relationships and confidential information that are specific to your practice and its success. As your practice grows, you know you will need to hire more employees. You also understand, however, that any potential employee may pose a risk…
Cigna Ends Preauthorization Requirement to Treat Opioid Addiction
(Reuters)—Health insurer Cigna Corp. has discontinued its policy of requiring doctors to seek authorization before treating opioid addicts, as part of a fight against an epidemic of opioid abuse, New York Attorney General Eric Schneiderman said on Friday. The policy change will apply nationally, says Schneiderman, who has been pushing for easier access to treatments…
Tenet Healthcare to Pay More Than $513 Million in Fraud Scheme
WASHINGTON (Reuters)—U.S. hospital chain Tenet Healthcare Corp. and two of its Atlanta-area units will pay more than $513 million to resolve criminal charges and civil claims relating to a scheme to defraud the U.S. and pay kickbacks in exchange for patient referrals, the U.S. Department of Justice said on Monday.1 Tenet had disclosed in August…
Big Pharma vs. Big Pharma in Court Battles over Biosimilar Drugs
ZURICH (Reuters)—The line dividing makers of brand-name drugs and copycat medicines is blurring as companies known for innovative treatments queue up to peddle copies of rivals’ complex biological medicines. These drug makers are now increasingly straddling both sides of the courtroom, too, protecting their high-price products from biosimilars—biopharmaceutical drugs with the treatment properties of medicines…
What Rheumatologists Should Know about Purchasing a Healthcare Practice
After extensive research and careful deliberation, you have finally made the exciting but daunting decision to purchase a healthcare practice. You know that in the next couple of months you are going to need to examine the practice from a different perspective—one of a future owner. You also recognize that in order to facilitate the…
How to Maintain HIPAA Compliance
In 2010, the federal government published a guide, titled Basic Security for the Small Healthcare Practice, complete with best practices and checklists to help small providers achieve and maintain HIPAA compliance.1 This year, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR)—following a critical report of its HIPAA compliance audit and enforcement…
New York City Hospitals Settle Medicaid Repayment after Fraud Charges
NEW YORK (Reuters)—Three hospitals in New York’s Mount Sinai Health System will pay $2.95 million to settle Medicaid fraud charges for taking two years to repay more than $844,000 of improper billings that had been flagged by a whistleblower, authorities say on Wednesday. The accord resolves claims that Mount Sinai Beth Israel, Mount Sinai St….
Aetna CEO Warned It Would Cut Obamacare If Humana Deal Was Blocked
NEW YORK (Reuters)—Aetna Inc.’s CEO said in a letter to the U.S. Department of Justice (DOJ) during the review of its deal to buy rival Humana Inc that the insurer would exit much of the individual Obamacare insurance market if the agency challenged the merger. In the July 5 letter, Chief Executive Officer Mark Bertolini…
Cephalon, U.S. States Reach $125 Million Settlement Over Generic Drugs
WASHINGTON (Reuters)—Cephalon has reached a $125 million settlement with 48 states in connection with its alleged efforts to delay generic versions of its blockbuster sleep disorder drug modafinil (Provigil) from entering the market, New York Attorney General Eric Schneiderman said on Thursday. The settlement with Cephalon, now owned by Teva Pharmaceuticals, comes a little more…
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