Payer Roundup—AHIP partners with American Telemedicine Association; CEO charged in $200M fraud scheme

Telemedicine consultation
AHIP partners to enhance telehealth awareness; Trump considers a name change for HHS. (Getty/AndreyPopov)

AHIP, ATA team up to promote telehealth 

America's Health Insurance Plans (AHIP) is teaming up with the American Telemedicine Association (ATA) to "enhance consumer access to health services via telehealth," according to an announcement co-authored by ATA's CEO and the CMO of AHIP.  

Highlighting the convenience of virtual care and the impact telehealth can have on managing chronic conditions, the groups said they plan to highlight the best practices and trends of telemedicine, along with the barriers that still need to be addressed.  

"Telehealth can increase access to primary and specialty care, improve quality and patient engagement, better leverage clinician expertise and time, all while saving money," the CEOs wrote. "As this great potential turns into reality, the American Telemedicine Association and America’s Health Insurance Plans will showcase the many ways telehealth services can benefit consumers, patients and providers." (Announcement

CEO of pain clinics, 4 physicians charged in $200M fraud scheme 

The CEO of Tri-County Wellness has been charged, alongside four physicians, with a healthcare fraud scheme in which they distributed 4.2 million medically unnecessary dosages of controlled substances.  

Mashiyat Rashid, the CEO of the organization that operated pain clinics, labs and other provider services throughout Michigan and Ohio, is accused of forcing Medicare beneficiaries to "submit to expensive, medically unnecessary and painful injections" to obtain pain medications, according to a superseding indictment from the Department of Justice. Rashid also owned a diagnostic laboratory and had the four physicians submit unnecessary urine drug tests, billing Medicare nearly $7 billion.  

“This multi-agency investigation has led to one of the largest healthcare fraud and illegal distribution of prescription drugs indictments this district has ever seen,” U.S. Attorney Matthew Schneider of the Eastern District of Michigan said in a statement. (Release)  

Trump reorganization plan could include HHS changes 

The Trump administration is planning to release a new plan that would reorganize and consolidate multiple agencies and programs, including the Health and Human Services Department—even calling for a name change for the agency. 

Politico reported the plan will be released later this month by the White House Office of Management and Budget. They said the plan would target safety-net programs such as food stamps. 

Exactly what changes might come for HHS are not clear, but it was reported the new name for the agency would emphasize programs that provide assistance to low-income people. (Politico article