Morning Briefing
Summaries of health policy coverage from major news organizations
Grassley Wades Into Hotly Contested 340B Drug Debate With Transparency Legislation
Stat: Grassley Joins The Debate Over Drug Discounts With Bill Pushing Hospitals To Disclose Payments
A senior Republican senator is wading into the debate over a controversial drug discount program with new legislation to require more transparency from hospitals that participate. Sen. Chuck Grassley (R-Iowa) dropped legislation Thursday that takes aim at the so-called 340B program, which forces drug companies to give some public and nonprofit hospitals discounts on medicines. Through Medicare, the federal government then reimburses the facilities for the drugs at a higher rate. (Mershon, 3/1)
In other Medicare news —
Modern Healthcare: Justice Department Faces Uphill Battle In Medicare Advantage False Billing Cases
The U.S Justice Department recently has been dealt heavy blows in its quest to recover millions in allegedly fraudulent Medicare Advantage payments to UnitedHealth Group. But the federal courts have laid out a roadmap, albeit a demanding one, for how the federal government could win future cases. The federal government on Friday ditched most of its False Claims Act lawsuit over Minnetonka, Minn.-based UnitedHealth's Medicare Advantage billing practices. That setback came just a few months after UnitedHealth defeated the Justice Department in a similar lawsuit accusing the nation's largest insurer and affiliated health plans of exaggerating how sick its patients were to score millions of dollars in inflated Medicare Advantage payments. (Livingston, 3/1)
Modern Healthcare: New CMS Guidance Could Stop Rehab Claims Denials
Pennsylvania-based Post Acute Medical has lost hundreds of thousands of dollars due to rejected Medicare claims because of a matter of mere minutes. Claims are rejected if patients miss just minutes of their minimum time for daily inpatient rehabilitation therapy. Medicare pays for the therapy if beneficiaries participate at least three hours a day. But Post Acute Medical, a long-term acute-care facility operator, sees Medicare deny 20% to 25% of its inpatient rehab claims when patients miss that threshold by just minutes. (Dickson, 3/1)
