News for Insurers
Top stories summarized by our editors
4/20/2018

Santa Cruz County, Ariz., achieved a gold level award from the Healthy Arizona Worksites initiative for its data-driven employee wellness program, which includes offering discounted Fitbit trackers and step competitions for workers. The county also plans to open a lactation room at the County Complex, offer fruit in the break room, have cooking demonstrations and add healthier foods to vending machines.

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Fitbit
4/20/2018

The City Employee Benefit Trust Fund Committee in La Crosse, Wis., approved a one-year wellness pilot program with Riverside Corporate Wellness that will include 50 city hall employees. The program will provide employee risk assessments and access to personal trainers and coaches, a registered dietitian and a smoking-cessation specialist.

4/20/2018

Adults who survived a heart attack reduced their risk of dying within four years by 51% if they increased their exercise levels, researchers reported at a European Society of Cardiology conference. Researcher Orjan Ekblom said exercise could include all types of activities with an intensity equal to at least a brisk walk.

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CTV.ca (Canada)
4/20/2018

A guidance document will enable payers and drugmakers to negotiate contracts for off-label uses of approved drugs, FDA Commissioner Scott Gottlieb said. "The health system and the payers who are making these decisions are not only very sophisticated, their sort of implicit approach to these things is they are trying to save money ... so they are going to look at data through a skeptical eye," Gottlieb said.

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Commissioner Scott Gottlieb, FDA
4/20/2018

The FDA will relax standards for demonstrating that biosimilar drugs are interchangeable with their reference products, FDA Commissioner Scott Gottlieb said at the Pharmaceutical Care Management Association's policy forum.

4/20/2018

Hours after Allergan expressed interest in the acquisition of rare disease drugmaker Shire, the company said it would not make an offer for the company. Takeda has offered $62.5 billion to purchase Shire.

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Endpoints News, Fortune
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Allergan, Takeda
4/20/2018

Ilya Babiner, a dentist from Bucks County, Pa., was ordered to pay $1.5 million in restitution and have his license to practice revoked for at least seven years after entering a guilty plea to Medicaid fraud and tempering of public records. Authorities say Babiner submitted $1.5 million worth of fraudulent claims to Medicaid for unprovided and repeat dental care services over a two-year period.

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Patch
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Ilya Babiner
4/20/2018

Sajid Javed, who owns and operates nine pharmacies in the New York City area, pleaded guilty to conspiracy to commit health care fraud in an $8.5 million-plus scheme to defraud Medicaid and Medicare. Javed admitted to paying kickbacks to customers in exchange for not receiving their prescribed medications, and to submitting over $8.5 million worth of fraudulent claims to Medicare and Medicaid for the undispensed medications between January 2013 and July 2015.

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Department of Justice
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Medicare
4/20/2018

Biotheranostics, a diagnostic laboratory testing company in San Diego, agreed to a $2 million settlement deal to resolve accusations that it defrauded Medicare. Authorities say the firm caused the submission of fraudulent claims to Medicare for its Breast Cancer Index test by deliberately promoting and using the test in breast cancer patients for whom the test was not necessary and reasonable based on clinical guidelines.

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Times of San Diego
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BioTheranostics
4/20/2018

Rafael Prats, a physician from Miami, received a three-year probation term after entering a guilty plea to charges including conspiracy to commit theft of medical products. Prats and his co-defendants were accused of reintroducing counterfeit drugs, expired drugs, dispensed drugs of known and unknown origin, and drugs not authorized for resale into the market for eventual sale to pharmacies and customers, court records show.

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Department of Justice
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Rafael Prats