Former billing manager gets $1.4 million for employer retaliation; Glenmark Generics settles for $25 million;

News From Around the Web

> A former billing manager for Harrison Medical Center in Tacoma, Washington was awarded $1.4 million for retaliation and wrongful termination during a Medicare fraud investigation. Lori Cook was fired from her position when she reported potential fraud implications to her supervisor, after reviewing backlog of Medicare billing claims. Even though Harrison argued the provider never submitted false claims, the jury found that Cook was still protected from retaliation under the False Claims Act. Article

> Glenmark Generics Inc. paid $25 million to resolve a Medicaid fraud investigation initiated by Texas Attorney General Ken Paxton. The New Jersey-based pharmaceutical company will pay the state of Texas and the United States $11.25 million each, along with $2.5 million in attorney's fees paid to the Attorney General's office. Release

> Four additional counts of healthcare fraud have been added to charges filed against the owner of Alpha Diagnostics for his involvement in a $7.5 million Medicare and Medicaid fraud scheme. Rafael Chikvashvili allegedly created false radiology, ultrasound, and cardiologic interpretation reports, which were submitted for reimbursement. The new charges indicate that four patients died because their X-rays were not read by a qualified radiologist, leading to unnecessary surgeries and failure to detect certain health conditions. Release

Health Payer News:

> A new report indicates that predictive analytics will play a big role in helping payers manage risk. As the healthcare sector takes on value-based reimbursement models, analytics will help drive improved outcomes and track quality performance metrics in order to identify patients that are more likely to require care. Article

> Medicaid expansion is faltering in some states, and prospering in others. Over the past several weeks, states like Montana and Ohio have made legislative moves to expand Medicaid, whereas a proposal for healthcare expansion in Tennessee, submitted by Gov. Bill Haslam (R), was shot down by a GOP legislature. Article

And finally … Here's one way to get rid of your mother-in-law. Article

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