The Four Things That Surprised Us in the EpiPen False Claims Settlement

On August 17, 2017, the U.S. Department of Justice (DOJ) announced that it had reached a $465 million false claims settlement with Mylan, the manufacturer of EpiPen, over the company’s alleged underpayment of Medicaid Drug Rebates for EpiPen. The settlement amount and terms were generally announced by Mylan in October 2016 – but back then DOJ refused to confirm the settlement. View Full Post
Tweet Like LinkedIn LinkedIn Google Plus

Ontario Considers Requiring Disclosure of Drug Company Payments to Healthcare Providers

The Government of Ontario has announced it is consulting with patients, healthcare providers, and the pharmaceutical and medical devices industries about current regulations and guidelines that govern the disclosure of payments from the private sector to healthcare professionals. Although some innovative pharmaceutical companies already voluntarily disclose payments to healthcare providers, Ontario is assessing what additional measures should be implemented to increase transparency, including possibly mandating disclosure of payments by private drug companies to healthcare providers. View Full Post
Tweet Like LinkedIn LinkedIn Google Plus

Implied False Certification Theory Fails in FCA Case Against Billing Agent

A court in the Southern District of New York (“SDNY” or the “Court”) recently released an important decision applying the Supreme Court’s landmark Escobar ruling to a qui tam action involving percentage fee arrangements for billing agents.  Among other claims, the City of New York (“the City”) and its billing agent, Computer Sciences Corporation (“CSC”) allegedly used an illegal incentive-based compensation arrangement for CSC’s services when billing New York Medicaid for services provided to eligible children under New York’s Early Intervention Program (“EIP”).    View Full Post
Tweet Like LinkedIn LinkedIn Google Plus

Trends in Medical Board License Defense in California

By | California License Law Blog | August 23, 2017
The California Medical Board received 8,679 complaints in fiscal year 2015-16 according to its latest comprehensive enforcement activity report.  During that same period, 299 accusations were filed by the Medical Board of California.  Medical license defense cases came from complaints overwhelmingly from the public, but also from complaints from license and professional groups and other governmental agencies.   View Full Post
Tweet Like LinkedIn LinkedIn Google Plus

Health Centers: The Federal Government Delivers a Big Win

By | New York Health Law | August 21, 2017
On August 15, 2017, the Secretary of Health and Human Services, Tom Price, issued a press release reporting that almost $105 million dollars will be bestowed upon 1,333 health centers across the United States, including its territories and Washington D.C. Secretary Price stated “Americans deserve a healthcare system that’s affordable, accessible, of the highest quality, with ample choices, driven by world-leading innovations, and responsive to the needs of the individual patient. View Full Post
Tweet Like LinkedIn LinkedIn Google Plus

CBO Releases Report On Effects of Terminating ACA Cost-sharing Reduction Payments; CMS Proposes to End Two Incentive Payment Models

By | Health Law Pulse | August 21, 2017
On August 15, the Congressional Budget Office (“CBO”) released a report on the effects of terminating payments to insurers for cost-sharing reductions under the Affordable Care Act (“ACA”) in 2017. The CBO estimated that by 2018, insurance premiums for silver plans would increase by 20 percent and leave 5 percent of Americans living in areas without insurers in ACA marketplaces. View Full Post
Tweet Like LinkedIn LinkedIn Google Plus