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DOJ Intervenes in FCA Lawsuit Filed Against Medical Device Maker Print E-mail
Written by Vitale Health Law   
Tuesday, 06 August 2019 15:44

The U.S. Department of Justice has intervened in a whistleblower lawsuit filed against medical device maker Life Spine Inc., along with the company's founder and its VP for Business Development. The lawsuit alleges that the company paid millions of dollars in kickbacks to surgeons in exchange for using its spinal implants, equipment and other devices. It's alleged the surgeons who received these payments accounted for approximately half of Life Spine's total domestic sales of spinal products from 2012 through 2018. The original qui tam lawsuit was filed under seal in 2018 by BNHT LLC under the False Claims Act. The Relators were identified as four former Life Spine employees. The False Claims Act allows those who discover fraud to sue on behalf of the government. The government can choose to intervene, as it did in this case, or allow the case to move forward privately. The Relators, in turn, can receive a percentage of what is recovered.
 
Anthem irks docs Print E-mail
Written by FHI's Week in Review   
Monday, 05 August 2019 17:19

Samantha Liss reports for Healthcare Dive on 8.2.19:  
 
Anthem is again ruffling the feathers of providers. This time over a new reimbursement policy denying payment for certain follow-up office visits the same day a procedure is performed. The policy could impact many specialists and primary care doctors... It's the latest in a string of controversial policies from Anthem. The Blue Cross payer that insures 40 million people has taken steps to rein in costs by enforcing different payment policies based on site of care and other factors... As deductibles rise and patients are shouldering a greater burden of the cost of care, insurers may be feeling the pressure from employers to wring out costs from the provider side... For providers, the big fear is the change will result in unjustified claim denials and encourage other payers to adopt similar measures.

Read more in the current issue of Week in Review>>

Last Updated on Thursday, 19 September 2019 10:00
 
This college dropout was bedridden for 11 years. Then he invented a surgery and cured himself Print E-mail
Written by FHInews   
Tuesday, 30 July 2019 17:25

Ryan Prior reports for CNN on 7.27.19:
 
Doug Lindsay was 21 and starting his senior year at Rockhurst University, a Jesuit college in Kansas City, Missouri, when his world imploded. After his first day of classes, the biology major collapsed at home on the dining room table, the room spinning around him. Itwas 1999. The symptoms soon became intense and untreatable. His heart would race, he felt weak and he frequently got dizzy. Lindsay could walk only about 50 feet at a time and couldn't stand for more than a few minutes. "Even lying on the floor didn't feel like it was low enough," he said. The former high school track athlete had dreamed of becoming a biochemistry professor or maybe a writer for "The Simpsons." Instead, he would spend the next 11 years mostly confined to a hospital bed in his living room in St. Louis, hamstrung by a mysterious ailment.
 
 
U.S. Overdose Deaths Dipped In 2018, But Some States Saw 'Devastating' Increases Print E-mail
Written by FHI's Week in Review   
Monday, 22 July 2019 16:58

Selena Simmons-Duffin reports for NPR via Health News Florida on 7/18/19:  
 
Good news came out from the Centers for Disease Control and Prevention Wednesday: Preliminary data shows reported drug overdoses declined 4.2% in 2018, after rising precipitously for decades...But not everyone was celebrating. Some states actually saw double-digit increases.
    
"It is still a nightmare. And the danger in media over-portraying this is actually quite substantial," says Shawn Ryan, MD, an addiction doctor in Ohio and past-president of the Ohio Society of Addiction Medicine. "If we look at just that decrease nationally - which is not that big - we're missing the point. In order to get back to baseline, we have a very long way to go." 

Read more in the current issue of Week in Review>> https://conta.cc/32TkEro

Last Updated on Friday, 06 September 2019 17:15
 
Florida Hospitals Eye New Transplant Programs Print E-mail
Written by FHI's Week in Review   
Monday, 15 July 2019 17:30

Christine Sexton reports for News Service of Florida via Health News Florida on 7/12/19:  

It's been less than two weeks since Florida jettisoned some long-standing regulations for hospitals, but several facilities across the state are already gearing up to expand medically complex services, such as transplants. For the last two years, five hospitals have shown an interest in offering new high-end services, but they were unable to do so because of the state's certificate-of-need (CON) requirements...But now that...law has been eliminated...

John Couris, CEO of Tampa General Hospital, has an excellent blog post addressing the CON repeal and the potential consequences. He points out that "procedure volume is critical in order to have positive patient outcomes."  Cleveland Clinic Florida CEO Wael Barsoum is a proponent of the CON repeal, stating "I'm glad it's gone...It's better for our communities and better for our patients. Competition is a good thing. It drives lower costs and it drives better quality." Santiago Leon, JD, Associate Director, Health & Benefits at Willis Towers Watson in Miami is not impressed with Dr. Barsoum's argument. "Great, now we get more low-volume teams doing complex operations," he states sarcastically.

Read more in the current issue of Week in Review>>

Last Updated on Monday, 15 July 2019 17:59
 
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