Humana Strikes $90 Million Settlement In Lawsuit On Medicare Overcharges
The agreement would settle a lawsuit by a whistleblower who alleges that the health insurer overcharged the federal Medicare program while administering prescription drug benefits. Humana did not admit wrongdoing in the agreement.
Reuters:
Humana To Pay $90 Mln To Settle Claim That It Overcharged Medicare For Drugs
Humana has agreed to pay $90 million to settle a whistleblower lawsuit by one of its former actuaries accusing the health insurer of overcharging the U.S. government for prescription drugs, the whistleblower's lawyers announced on Friday. The whistleblower, Steven Scott, said that Humana, which contracts with the federal Medicare program to administer prescription drug benefits, misrepresented its true costs in order to get a more lucrative contract. It is the first settlement with any insurer over allegations of fraud tied to Medicare's prescription drug contracting process, according to the law firm Phillips & Cohen, which represents Scott. (Pierson, 8/16)
The Wall Street Journal:
The Feds Are ‘Playing Nice’ With Pharma, At Least For Now
The government’s announcement confirmed what companies had been telegraphing in second-quarter results calls: The initial hit to earnings from the Inflation Reduction Act, which allows Medicare to directly negotiate the prices of some drugs, is going to be mild. There are a few reasons for that. For one, many drugs were already going off patent soon and therefore were set to face price erosion anyway. Secondly, the drugs are already discounted in order to be placed on pharmacy-benefit managers’ formularies. (Wainer, 8/16)
In other pharmaceutical news —
Stat:
Novo Holdings Deal To Boost Wegovy Supply May Face FTC Review
As the Federal Trade Commission scrutinizes the pharmaceutical industry, there is growing debate about whether the regulator may next target a deal that some experts say could make it easier for Novo Nordisk to boost production of a key drug — at the expense of competitors. (Silverman, 8/19)
The Washington Post:
Weight-Loss Drugs Are A Hot Commodity. But Not In Low-Income Neighborhoods.
Ozempic and other GLP-1 drugs were supposed to revolutionize the battle against obesity. But evidence shows big economic and racial disparities in access. (Cha, 8/19)
The Washington Post:
Antibiotics May Help People Avoid Surgery For Appendicitis
Though appendectomies have been the gold standard of care since before the turn of the 20th century, doctors have been treating appendicitis with antibiotics since the 1950s, as soon as they became available — a “dark secret” in the surgery world, says David R. Flum, professor of surgery and director of the Surgical Outcomes Research Center at the University of Washington. (Dattaro, 8/17)
The New York Times:
The Painkiller Used For Just About Anything
In huge numbers, older people are taking gabapentin for a variety of conditions, including itching, alcohol dependence and sciatica. “It’s crazy,” one expert said. (Span, 8/17)
