OIG Reports Reveal 3 Health Insurers’ Medicare Advantage Overcharges

Modern Healthcare: Medicare Advantage Overpayments Highlighted In OIG Reports
Three health insurance companies overcharged taxpayers by more than $140 million combined by exaggerating the severity of Medicare Advantage members' illnesses, according to reports the Health and Human Services Department Office of Inspector General published Thursday. Humana, HealthAssurance Pennsylvania — a unit of CVS Health subsidiary Aetna — and EmblemHealth deny the accusations and reject the OIG's recommendations that the Centers for Medicare and Medicaid Services recoup a portion of the alleged overpayments. (Early, 9/26)

The New York Times: Acadia Hospitals Reach $20 Million Settlement With Justice Dept. 
Acadia Healthcare, one of the country’s largest for-profit chains of psychiatric hospitals, has agreed to pay nearly $20 million to settle a federal investigation accusing the company of defrauding taxpayer-funded health insurance programs like Medicare and Medicaid, the Justice Department said on Thursday. Prosecutors said that Acadia had held patients for longer than necessary and admitted people who didn’t need to be there. Once patients entered its facilities, the government said, Acadia failed to provide therapy and kept staffing dangerously low, leading to assaults and suicides. (Thomas and Silver-Greenberg, 9/26)

Modern Healthcare: Hospital Charity Care Part Of 2 Reports On Tax Breaks
Two recent reports attempt to put a number on the value of nonprofit hospitals' tax breaks. As nonprofit health systems and hospitals grow, a smaller number of organizations account for a larger share of total tax exemptions, including income, sales and property tax. The dynamic has reinvigorated a debate on nonprofit hospitals’ tax-exempt status among industry groups and policymakers, along with other stakeholders. (Kacik, 9/26)

Modern Healthcare: Ascension Cyberattack Prompts Revised Outlook From Moody's
Moody's Investors Services revised its outlook for Ascension to negative, from stable, due to the health system's cybersecurity incident and concerns over its ability to improve its financial position. However, the credit ratings agency said it affirmed its ratings for Ascension's senior bonds, subordinated bonds and commercial paper instruments. (DeSilva, 9/26)

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AP: A Top Government Scientist Engaged In Research Misconduct, NIH Finds
A National Institutes of Health investigation has found research misconduct by one of its top neuroscientists, the agency said Thursday. In a statement, the NIH said the findings involve images in two studies co-authored by Dr. Eliezer Masliah, who in 2016 joined the agency’s National Institute on Aging as its neuroscience division director. NIH said images or “figure panels” that represented different experimental results were reused or relabeled in the publications. NIH said it would notify the two scientific journals of the findings “so that appropriate action can be taken.” (9/26)

The Wall Street Journal: George Berci, an Evangelist for Less-Invasive Surgery, Dies at 103
As a medical student in Hungary in the 1940s, George Berci wasn’t satisfied simply to master surgical techniques. He was determined to improve them. When his career took him to Australia and then Los Angeles, Berci explored the possibilities of what is today known as minimally invasive or keyhole surgery—the practice of reaching deeply into the body with a tube threaded through an orifice or small incision in the skin. Although such techniques had been proposed and tried since the 19th century, they were still rare in the 1960s and 1970s when Berci was a researcher refining them. (Hagerty, 9/26)