Former Novartis sales reps are expected to testify that they plied doctors with paid speaking engagements, expensive meals and booze in exchange for prescriptions and that drugmakers paid physicians for speaking engagements that never took place.
Spark Therapeutics' new therapy for a specific genetic mutation that causes blindness is priced at $425,000 per eye.
Mercy Health nurses will coordinate care for Cigna subscribers through Cigna's Collaborative Care program, and Cigna case managers will work with nurse care coordinators at Mercy to improve collaboration under the new agreement. Tufts Health Plan and Hartford Healthcare also entered a coordinated care agreement and are seeking CMS approval on a new plan, called CarePartners of Connecticut, to coordinate care for Medicare Advantage subscribers.
Arizona Care Network is testing Solve.Care's blockchain platform to see if it improves patient outcomes, reduces waste and alleviates administrative burdens under the accountable care organization's various value-based care contracts. The ACO will use the platform to distribute awards and incentives to health care providers during the first phase of the pilot and give patients access to a benefits and records app during the second phase.
Andrea Prenez, owner of Sweet Counseling Services in Thomaston, Conn., received a 10-year prison term suspended after 67 months plus three years of probation and was ordered to pay $661,000 in restitution to Medicaid after pleading guilty to identity theft and larceny by defrauding a public community. Prenez admitted to using the identity and credentials of a relative to submit over $661,000 worth of fraudulent claims to Medicaid for unprovided services or services she could not legally render.
Richard Rydze, owner of Optimal Health Center in Pittsburgh and a former physician for the Pittsburgh Steelers, received a 10-year prison term and was ordered to pay $50,690 in restitution and special assessments after being convicted of 180 counts, including charges of illegal distribution of controlled substances, human growth hormones and anabolic steroids. Authorities say Rydze prescribed anabolic steroids for unauthorized uses and conspired with others to illegally distribute opioid drugs including Vicodin and oxycodone, among other offenses.
Alfredo Cervantes, a psychiatrist from Abingdon, Va., was indicted on charges of health care fraud, unlawfully distributing a Schedule IV controlled substance, and wire fraud. Cervantes is accused of improperly prescribed controlled substances to a patient with whom he had personal relations and caused Virginia Medicaid and other insurers to reimburse claims for unnecessary prescription drugs and psychotherapy treatments, the indictment says.
Funding for cost-sharing reduction payments and a reinsurance program was left out of House spending legislation amid a dispute over language that Republicans say is standard but Democrats say would expand restrictions on abortion. The Senate is considering a vote to add the Affordable Care Act stabilization measures to the spending package, but the effort might not gain enough support.
The Physicians Advocacy Institute reported that US hospitals bought up 5,000 independent physician practices between July 2015 and July 2016. The percentage of hospital-employed physicians increased by more than 63% from mid-2012 to mid-2016.
A National Center for Health Statistics report that included self-reported data found that while 31.4% of Americans are obese, 54.8% met federal guidelines for aerobic activity. Obesity and exercise rates both showed increases over time, but there were some variations by gender, race and age.