Wyeth and Pfizer Agree to Pay $784.6 Million to Resolve Lawsuit Alleging That Wyeth Underpaid Drug Rebates to Medicaid

https://www.justice.gov/opa/pr/wyeth-and-pfizer-agree-pay-7846-million-resolve-lawsuit-alleging-wyeth-underpaid-drug-rebates

DOJ Building

http://www.fiercehealthpayer.com/antifraud/story/pfizer-pays-785-million-resolve-drug-pricing-allegations/2016-05-02?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiTWpVd1lqSTNZalZsWWpReCIsInQiOiJINE9BNitVSm1VYUR3NFVOZG1YMFFiVFQ2d2lmRGtEZ01NdjVpY0x2bmZUSmxTVFFcL2NcL3FMTmlGaXJqRFhSUHI2Tm1yK0Q1MHU1R3U2OWlGQ3NVYU9uTll2VXMxcEJSdUxlcGlYSjJEV1ZBPSJ9

CMS finalizes 85 percent medical loss ratio for Medicaid private managed care plans

http://www.healthcarefinancenews.com/news/cms-issues-final-rule-private-medicaid-plans?mkt_tok=eyJpIjoiWkRjM1pHWXhaamRtTjJJdyIsInQiOiIrNU1UM0tidlREYndvZ05BQ1hESEZUaFZUV3Jkd0lDVnZTRVhkaWQ3cTZ2ZHJIMk9SZ0ZSSEZGdDhKK3BJS3V4RkkzdDcrR2Y1MDd1K0FabllGQ1p2ZjdGanAybDlCUFJBRWo4eFVRK1IwRT0ifQ%3D%3D

Insurers must spend at least 85 percent of their Medicaid revenue on medical care to improve quality.

Study finds that 23 percent of diabetes treatment cost is avoidable

http://www.revenuecycleinsights.com/news/study-finds-23-percent-diabetes-treatment-cost-avoidable?mkt_tok=eyJpIjoiWldFNU1tWTBaR1JqTXpnNSIsInQiOiJLaDg2S09aMU56ektiYytVNFZKTWduSzlvXC8rSjRreTZzS1h0RWpINzJ6XC8zYjdKbFVOMXIwRXFCQ1RuTVNldVwvaks4YnNNTE9UeVwvMGVKenczVm9WZGRkVlVvWXBWT1BHT08yR0NvVGVqaVE9In0%3D

It is estimated that 1 out of 3 people can be expected to develop the disease in their lifetime. The majority of diabetes patients were found to experience at least one potentially avoidable complication, with a cost averaging  $1,043 per year for patients with private insurance and $1,869 for those with Medicaid. The authors believe the results illustrate the value of using analytics on patient data, supporting the objectives of population health initiatives to identify opportunities for improving treatment while lowering cost.

CMS may ban Theranos founder Elizabeth Holmes for 2 years, sanction company, WSJ says

http://www.healthcarefinancenews.com/news/cms-may-ban-theranos-founder-elizabeth-holmes-2-years-sanction-company-wsj-says?mkt_tok=eyJpIjoiT0RZMFptTmtNMlJsTUdVMiIsInQiOiJuZjAwWEdTaDd6S0hXT0NjTlwvMXlTZ0oySVBWN3RFUFBcL1JGeDVWMFBSMEp4ekR6cFJXUjRhOEIrUkNVbEZuZFlBanQ0a3FPZ2Nzem1QbnQzZUxITDRKTlFVcjFTazRpc2ZVb0doR0lQTGRBPSJ9

If the company doesn’t respond to the satisfaction of the regulators, CMS will impose the sanctions.

Maryland doctor sentenced for insurance fraud ordered to repay $3.1 million

http://www.healthcarefinancenews.com/news/maryland-doctor-sentenced-insurance-fraud-ordered-repay-31-million?mkt_tok=eyJpIjoiT0RZMFptTmtNMlJsTUdVMiIsInQiOiJuZjAwWEdTaDd6S0hXT0NjTlwvMXlTZ0oySVBWN3RFUFBcL1JGeDVWMFBSMEp4ekR6cFJXUjRhOEIrUkNVbEZuZFlBanQ0a3FPZ2Nzem1QbnQzZUxITDRKTlFVcjFTazRpc2ZVb0doR0lQTGRBPSJ9

Prison Cell

Paramjit Singh Ajrawat performed less expensive procedures but falsely billed for procedures that provided higher reimbursement amounts.

40 things to know about healthcare costs

http://www.beckershospitalreview.com/finance/40-things-to-know-about-healthcare-costs-january13.html

Money Physician

Healthcare Coverage Breakout for the Entire U.S. Population in 1 Chart

http://acasignups.net/16/04/05/show-your-work-healthcare-coverage-breakout-entire-us-population-1-chart

Uninsured Rate Hits New Low, but Obamacare’s Still a Hot Potato

http://www.thefiscaltimes.com/2016/04/07/Uninsured-Rate-Hits-New-Low-Obamacare-s-Still-Hot-Potato?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=28219019&_hsenc=p2ANqtz-9CqoUkOE-ruW6sskXIyCsiJ0szh7xQil7MXSHLEt2i8kJ9VvAEl3hrKiYNqbVzHlv1MZ2jQDVgYm9SzhnHQ5EsXYtv6g&_hsmi=28219019