News From Around the Web
> The owner of a Texas durable medical equipment (DME) supplier was sentenced to 63 months in prison for his role in a $3.4 million Medicare fraud scheme. Huey P. Williams owned and operated two DME companies outside of Dallas which he used to bill Medicare for fake "arthritis kits," giving patients cheap neoprene braces, which led Medicare to pay $1.9 million in false claims. Announcement
> Eduardo Carriollo, a doctor from McAllen, Texas, was convicted of healthcare fraud and aggravated identity theft as part of scam in which he submitted bills for physician services provided to deceased beneficiaries. Along with his assistant, Kenneth Magidson, Carriollo also solicited kickbacks in exchange for patient referrals, in which he provided a patient's Medicare number and personal information. Announcement
> The owner and chief operating officer of an attendant care services company pleaded guilty to a scheme in which the company billed for one-on-one services that were never provided. Barbara Sadler, owner of Extraordinary Care Network, Inc., and the company's COO Sedric Blakes, admitted to billing Medicare from 2006 to 2013 for services that weren't provided by forging signatures and falsifying progress notes. Announcement
Health Payer News
> A small number of new drugs account for a large portion of Medicare Part B spending, according to a Government Accountability Office (GAO) report. The GAO found that 20 high-expenditure drugs made up 92 percent of 2013 Part B spending on new drugs, and 26 percent of spending on all drugs. Over the past several years, spending growth has been driven by new Part B drugs. Article
> UnitedHealth Group announced that it is reevaluating its participation in Affordable Care Act individual exchanges, citing tempered growth expectations, failed co-operatives, and a higher risk marketplace. However, other payers have reported steady earnings through the third quarter of 2015, and the Obama administration said that UnitedHealth's reluctance is not part of a trend. Article
And finally… Call it the Uber for household chickens. Article