Justice Department Asks Court To Order Anthem Testimony In Medicare Billing Case
The request is part of an investigation into Medicare Advantage risk-adjustment payments. Also in the news, a study finds that Medicare could save $925 million if generic drugs were substituted for 29 expensive combination prescriptions.
Modern Healthcare:
Feds Want To Force Anthem To Comply With Medicare Billing Investigation
Health insurer Anthem has refused to comply with the U.S. Justice Department's investigation into its Medicare Advantage billing practices, according to federal court documents filed Tuesday. So the Justice Department this week asked the U.S. District Court for the Southern District of New York to force Anthem to comply with a civil investigative demand issued in March to provide testimony .... The Justice Department asked for Anthem's testimony as part of an investigation into whether Anthem unlawfully obtained hundreds of millions of dollars in Medicare Advantage risk-adjustment payments in violation of the False Claims Act by submitting inaccurate patient diagnosis codes to the CMS. (Livingston, 8/21)
Modern Healthcare:
Swapping Brand-Name Combo Drugs For Generics Could Save Medicare $1B A Year
Substituting 29 of the most expensive brand-name combination drugs with generic alternatives could have saved Medicare $925 million in 2016, according to a new study. Combination drugs like Nuedexta, which marries cough suppressant and low-dose quinidine to treat spontaneous crying or laughing, ideally reduce the number of pills a patient has to take and improve adherence. But that isn't the case when branded combination drugs are prohibitively expensive, as a new study published in JAMA highlights. ... The study also calls into question "me-too" drugs that are nearly identical to existing medications. (Kacik, 8/21)
