> Trinity HomeCare LLC, owned by Walgreen Co., announced a $22.4 million settlement with New York to resolve claims that the company improperly billed Medicaid for Synagis, a drug developed for at-risk premature infants. An investigation by the Attorney General's Medicaid Fraud Control Unit, following whistleblower claims by a hospital physician, found that the specialty pharmacy attempted to sell Synagis directly to patients regardless of whether it was prescribed. Additionally, the investigation found that the pharmacy billed Medicaid for Synagis prescriptions even when it lacked a valid prescription. The settlement marked the second between Trinity and the NYC AG in the last month. Announcement
> Six Houston residents, including two physicians, were arrested last week for allegedly participating in a $12 million healthcare fraud scheme. Mktrich "Mike" Yepremian, who owned and operated several clinics and a blood testing laboratory, allegedly paid three individuals to recruit Medicare and Medicaid patients so he could bill for medically unnecessary diagnostic and blood tests. The clinics were listed under "straw owners," but Yepremian controlled the funds derived from false claims. Announcement
> A New Jersey doctor was sentenced to more than five years in prison for accepting $1.8 million in kickbacks from Biodiagnostic Laboratory Services LLC (BLS). Frank Santangelo marked the 26th doctor sentenced in connection with the widespread kickback scheme that has captured 38 people and resulted in $100 million in false claims. Santangelo frequently received tens of thousands of dollars each month in bribes leading to $6 million in Medicare reimbursement for BLS. Announcement
Health Payer News
> Following cyberattacks against Anthem and Premera Blue Cross, The Blue Cross Blue Shield Association announced that it will offer identity protection services to all members starting in 2016. Services will include fraud detection and resolution reports, along with credit monitoring. Article
> After being nominated by President Barack Obama to serve as the next Centers for Medicare & Medicaid Administrator, former UnitedHealth Group executive Andy Slavitt was met with some skepticism regarding his ties to the insurance industry. While some legislators praised the nomination, others have said that Slavitt will be met with tough questions concerning his time with UnitedHealth. Article
And finally… What's the protocol on starting an underwater mosh pit? Article