News From Around the Web
> The former medical director of the now-defunct Health Care Solutions Network (HCSN), along with three therapists, were sentenced for a $63 million Medicare scheme involving unnecessary intensive mental health services. Roger Rousseau, who served as medical director of HCSN, was sentenced to 16 years in prison for signing off on fabricated and medical records and paying kickbacks to assisted living facility owners in Miami. The three therapists received sentences ranging from five to six years for fabricating medical records, which led to fraudulent Medicare payments. Announcement
> New York Attorney General Eric T. Schneiderman announced a $54 million Medicaid fraud settlement with AstraZeneca and Cephalon, a subsidiary of Teva Pharmaceuticals, which resolved claims that the companies falsely reported wholesale drug prices in an effort to decrease the rebates they owed through the Medicaid Drug Rebate Program. AstraZeneca will pay $46.5 million and Cephalon will pay $7.5 million, all of which will be divvied up among the 50 states, plus the District of Columbia and the federal government. New York is set to receive approximately $8.5 million of the settlement money. Announcement
> The owner of a Los Angeles medical supply company was convicted for his role in a $4 million Medicare fraud scheme involving power wheelchairs and orthopedic equipment. Valery Bogomolny, owner of Royal Medical Supply, billed Medicare for power wheelchairs, back braces and knee braces that were medically unnecessary. Bogomolny submitted fake home assessments and documentation for beneficiaries that were able to walk without assistance. Announcement
Health Payer News
> Two months after Excellus BlueCross BlueShield announced a cyberattack had exposed 10 million member records, the company still does not know how the breach occurred. Already, Excellus is facing a dozen lawsuits for potentially exposing health information, but the insurer says that hackers hid themselves by using legitimate credentials. Article
Health Finance News
> Geisinger Health System released a new app that will refund up to $2,000 to patients that are unhappy with their care. The app, called Geisinger ProvenExperience allows patients to rate their service and ask for a refund depending on the medical service and cost. Geisinger CEO David Feinberg, M.D., said he believes patients are more attuned to quality care and that the healthcare industry will be "disrupted the same way the taxi industry is (by Uber) or the hotel industry (with Airbnb)." Article
And finally… A day in the life of a 30-year-old bearded man named Taylor Swift. Article