Manufacturer of spinal surgery system pays $13.5M to settle false claims allegations; LA pharmacist gets 18 months for Part D fraud;

> Medical device manufacturer NuVasive Inc. has agreed to pay $13.5 million to settle federal false claims allegations linked to the company's spinal surgery system, according to the justice department. Prosecutors alleged that the California-based company promoted its CoRoent System for surgeries to treat complex spine deformities, severe scoliosis and severe spondylolisthesis, even though the system was not approved for those surgeries by the FDA. Additionally, NuVasive allegedly paid physicians to entice them to use the CoRoent. Announcement

> A Los Angeles pharmacist was sentenced to 18 months in prison for defrauding Medicare Part D. Rouzbeh Javaherian, who owned and operated Westaid Pharmacy and Medical Supply, paid kickbacks to beneficiaries to convince them to get their prescriptions through his pharmacy, according to the justice department. Javaherian also submitted claims for prescriptions he didn't fill, leading to more than $644,000 in overpayments. Announcement

> Pediatric Services of America, a Georgia-based healthcare network that provides home nursing services to disabled children, has agreed to pay $6.8 million to settle allegations that it failed to disclose and return overpayments from Medicare and Medicaid, the Atlanta Business Chronicle reports. Prosecutors alleged that the company submitted claims without documenting required monthly supervisory visits by a registered nurse. Article

Health Payer News

> Insurers are pushing back against federal and state scrutiny of health insurance premium hikes. Last month, the CEO of Healthcare.gov told state insurance commissioners to review proposed rate hikes; however, the president of the National Association of Insurance Commissioners said the mandate provides no additional information on how to regulate insurance markets. Meanwhile, some insurers say that claims have not slowed, and the health status of new customers has not improved, leading to necessary rate hikes. Article

> One-third of Medicare beneficiaries could face a 52 percent increase to Part B premiums barring intervention from the Department of Health and Human Services. Because Social Security is not scheduled for a cost-of-living increase in 2016, Medicare plans to increase premiums for those that don't qualify for the "hold harmless" provision of Social Security. Article

And finally…  Why did the chicken cross the road? To show off its prosthetic leg. Article

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