Sanofi-Aventis Pays $95.5M in a Federal Claim

According to this article in bizjournals, Sanofi-Aventis will pay $95.5 million to settle a federal claim that accuses Aventis Pharmaceuticals Inc. of underpaying drug rebates it was required to pay into Medicaid between 1995 through 2000. The Justice Dept claims that $49 million of the settlement will be paid to the federal government, $40 million will be paid to the states, and the remaining $6 million will go to heath providers.

Read the full article here.

States facing tough chioces, many cutting funding to Medicaid

With money tight in every corner, many states are being forced to cut budgets that fund state run Medicaid programs.

In North Carolina, a possible Medicaid budget cut would affect the home-bound elderly the most. Although the cost of living at home is much less than the elderly living in nursing homes. In Mississippi, budget cuts will also go towards Medicaid instead of education funding.

Solving the Healthcare Crisis

At Medicaid Managed Care this year Senator Tom Daschle will outlines the healthcare reform strategies based on his book, Critical: What We Can Do About the Health-Care Crisis, that are the foundation of President Obama’s healthcare plan. Evaluating where previous attempts at national healthcare coverage have succeeded and where they have gone wrong, he explains the complex social, economic, and medical issues involved in reform and sets forth his vision for change. As an in-demand healthcare speaker and the architect of Obama’s healthcare strategy, Daschle engages audiences in a productive and serious dialogue on healthcare reform and its impact.

At MMCC learn how to :
-Create successful marketing outreach programs
-Attract providers to work with the Medicaid market
-Integrate Medicare and Medicaid
-Work more closely with Medicare SNPs
-Manage the high-cost/ high-risk population
-Treat the uninsured population
-Economic outlook and implications for State Medicaid Programs
-Accurately measure quality through operational metrics
-Utilize health information technology for improved processes

For more information on Medicaid Managed Care Congress, click here.

Medicaid Drug Rebate Program: Your rebate calculations

On Tuesday, we posted about the trouble Wyeth is facing dealing with some of the rebates and Medicaid programs.

The justice department and multiple states are investigating Wyeth for Medicaid calculations fraud.... Would your organization’s rebate calculations withstand this level of scrutiny? .... It is ever-more important to attend the nation’s largest and most comprehensive Medicaid Drug Rebate event being held this September. To help you avoid the current non-compliance landscape costing manufacturers millions of dollars, the MDRP summit offers a chance to hear directly from top government officials and leading industry attorneys.

Meet face to face with USDOJ officials who describe lessons learned from current Medicaid fraud litigations, in sessions to keep you compliant.

Find out more about the conference here.

If you'd like to join a group of professionals in the MDRP field, join our Medicaid Drug Rebate Program LinkedIn Group!

Saving trillions in health care, one patient at a time

According to Public Radio International and WNYC, "The debate on healthcare reform proceeds in Washington will make news over the next several months, if the process results in actual healthcare reform. The beginning of the conversation involved a coalition of industry, private sector, and federal players coming together for a voluntary series of cost-cutting moves that involve creating incentives for people and the healthcare industry to do better to control costs."

To listen to their entire coverage on this story, please click the link below to hear the report.

Listen to PRI and WNYC's on-air discussion.

What steps are needed, the small steps, to get the big issue of healthcare reform solidified by the Obama administration?

Creation of HEAT hopes to combat Medicare fraud

Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius announced today the start of a new program called Healthcare Fraud Prevention and Enforcement Action Team (HEAT).

Health and Human Services Secretary Kathleen Seblius stated,
“Today, we are turning up the heat on perpetrators who steal from the taxpayers and threaten the future of Medicare and Medicaid. Most providers are doing the right thing and providing care with integrity. But we cannot and will not allow billions of dollars to be stolen from Medicare and Medicaid through fraud, waste and serious abuse of the system. It’s time to bring the fight against fraud into the 21st century and put the resources on the streets and out into the community to protect the American taxpayers and lower the cost of health care.”

Read the full story here.

Wyeth called out by Medicaid

According to The AP, Wyeth cheated Medicaid out of millions of dollars by overcharging for a the stomach acid drug Protonix. The Justice Department has joined in two lawsuits that were started by whistle blowers.

The court papers claim that between 2000 and 2006, Wyeth offered steep discounts to thousands of hospitals for two versions of Protonix, a drug that suppresses stomach acid.

By law, manufacturers of brand-name drugs are required to offer the same rebates to state Medicaid programs that they provide to other customers.

The government claims the maneuver helped the company avoid paying hundreds of millions of dollars in rebates to Medicaid, a health care program for the poor that is funded by state and federal money.

Read the full story here.

Young Adults Unclear About Health Care Options - Study

According to the Wall Street Journal, young adults who enter the working world are unclear about what coverage they should purchase for their healthcare needs. "Graduates are entering the real world without a sense of what to look for in a health plan and how to find coverage that is right for their needs," said Richard A. Collins, chief executive of UnitedHealth's Golden Rule Insurance Co.

The online poll of 1,000 18- to 21-year-olds found that 67% of young adults haven't made plans for health-insurance coverage after they leave school, even though 82% see health insurance as a necessity. The poll was conducted last month by UnitedHealth.

After reviewing the data, how will this study directly impact your healthcare business?

For more information, please click here.

Medicare will run out two years sooner

According to a report released yesterday, Medicare's trust fund will run dry two years sooner than projected last year, drying up in 2017. This is a result of fewer taxes being collected on incomes due to the current recession. The cost of running Medicare will also grow faster over the next few years than Americans earnings. Read the full story at MedPage Today.

KPMG's views on the new public policy environment in the United States: The impact on pharmaceutical and medical device companies

According to KPMG, change in healthcare policy is inevitable under the Obama administration. There is much speculation as to whether widespread reform will be implemented by the new leadership and if so, how and when this will occur. This eight-page special explores the impact of the new U.S. political environment on the pharmaceutical and medical devices industries.

Download the report here.

What will a public plan for health insurance mean for Medicaid Managed Care?

On April 1st millions of children previously uninsured became eligible for CHIP. This leaves just over 40 million additional adults who are currently uninsured. The Administration seems committed to a reform plan which would expand previously existing public program such as Medicaid. There will no doubt be tremendous debate and a contentious political fight regarding how this should be achieved. For 17 years, the Medicaid Managed Care Congress has brought together the nation’s leading Medicaid Health Plans and the States at the forefront of Medicaid Managed Care to operationalize best practices that drive measurable cost savings and quality improvements in Medicaid. This year, we have assembled the faculty who can ensure sustainability and success in this changing political landscape.

For more information, visit our Medicaid Managed Care website.
To network with others in this feild, join our Medicaid Managed Care LinkedIn Group.

New Health Care policies proposed in the Senate

Recently at the New York Times, they looked at the new proposal by was made Monday by Senator Charles E. Schumer of New York. The Senate began discussing this issue yesterday. Read the full story here.