Month: January 2018

OIG to Begin Telehealth Audits

OIG to Begin Telehealth Audits In November 2017, the U.S. Department of Health and Human Services’ (“HHS”) Office of Inspector General (“OIG”) announced that it plans to begin audits of telehealth services that receive Medicaid payments, and such audits have been added to the OIG Work Plan. The purpose of the audits is to ensure that Medicaid payments for services delivered through telecommunication systems comply with Medicaid’s requirements, which is important to stay on top of as the telehealth industry continues to grow and expand. These audits will apply to distant site claims for telehealth services, and not the...

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HHS On track to Allow Sharing of Patient Data With Pharmacists

HHS On Track to Allow Sharing of Patient Data With Pharmacists By advisory opinion issued on December 4, 2017, the U.S. Department of Health and Human Services’ Office of Inspector General (“OIG”) has announced that some pharmacists will now be given access to patient discharge data as part of a new pilot program designed to combat readmission rates and to create more effective post-discharge care plans for patients. Under the pilot program, drug manufacturers (who have to meet specified requirements to participate) would each work with a trade association, a Medicare Advantage plan and a hospital system. Pharmacists employed...

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Massachusetts Appeals Court Reinforces Insurers’ Contractual Rights to Settle Claims

Massachusetts Appeals Court Reinforces Insurers’ Contractual Rights to Settle Claims A recent Massachusetts Appeals Court decision, based upon New Hampshire law, found that a professional liability insurer did not breach the implied covenant of good faith and fair dealing by settling a New Hampshire medical malpractice suit – even though the settlement was against the wishes of the insured party. The insurer, Proselect Insurance Company (“Proselect”), defended the malpractice suit brought against its insured, a doctor who was accused of negligently failing to diagnose a stroke. The suit went to trial and resulted in a jury verdict against the...

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Shareholder Group Urges Big Pharma to Report Link Between Pricing and Pay

Shareholder Group Urges Big Pharma to Report Link Between Pricing and Pay Pharmaceutical company executives are among the highest paid individuals in the world, and pharmaceutical companies have been in the news frequently over the past few years for spikes in prescription drug prices. There are many that believe that drug prices are far too high, including some shareholders of these same companies. The Interfaith Center on Corporate Responsibility (ICCR), a coalition of shareholders and institutional investors that together have over $400 billion in assets, has reached out to Big Pharma and others to establish positive working relationships and...

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