Drug manufacturer Insys Therapeutics Inc. has agreed to pay $225 million in order to end federal investigations into allegations that it used illegal marketing schemes to push a powerful opioid-based painkiller. Federal prosecutors allege that company used kickbacks and veiled bribes in order to sell a fentanyl spray, called Susbys, which is designed for cancer patients suffering from severe pain. The company agreed to pay a $2 million criminal fine and forfeit $28 million. … [Read more...] about Insys Therapeutics Inc. to Pay $225 Million to End Opioid Investigation

An omnibus bill to "get more mental health services to students in Texas Public Schools," was signed into law by Governor Greg Abbott yesterday. The bill will require: "school districts to offer mental health and suicide prevention curricula if they do the same with physical health.  The curricula and training will include signs of mental health conditions and substance abuse, strategies for maintaining student to student positive relations, conflict resolution, and information about how grief … [Read more...] about Texas HB 18 Signed into Law by Gov. Abbott

  Despite a huge shortfall between reimbursement and the cost of care, two bills designed to partially alleviate that  failed: The failed legislation, Senate Bill 1050 and House Bill 3342, would have set up a long-term care quality provider participation program (QPPP) that provided additional compensation to SNFs that met certain quality metrics. … [Read more...] about Medicaid Rate Increase Fails in Texas Legislature

The PDPM takes effect on October 1, 2019.  You can read about the concerns being raised on behalf of nursing homes under the model here. … [Read more...] about Provider Concerns about Patient-Driven Payment Mode

CMS announced the increase on April 1, 2019: Today, the Centers for Medicare & Medicaid Services (CMS) finalized updates that will take significant steps in continuing the Trump administration’s efforts to increase competition among Medicare Advantage and Part D plans so patients get higher quality care at lower costs. These changes will increase plan choices and benefits, and include important actions to address the opioid crisis. “Today’s changes give plans the ability to be innovative … [Read more...] about CMS Increases Rates For Medicare Advantage Payments

On March 5, 2019, CMS sent a memo to the State Survey Agencies regarding revisions in Appendix Q, Guidance on Immediate Jeopardy.  Here is a summary of the key changes: Likelihood instead of potential:  This changes the previous version in that it clarifies that rather than a "potential for serious harm," in order to cite IJ in situations where residents or patients have not suffered serious injury, harm, impairment or death, the surveyor is to determine whether the noncompliance creates a … [Read more...] about The Revised Appendix Q

The Texas Medical Board is reporting that scammers posing as DEA agents are targeting physicians, pharmacies, and individuals for the purpose of extortion.   The United States Drug Enforcement Administration (DEA) is aware that registrants are receiving telephone calls and emails by criminals identifying themselves as DEA employees or other law enforcement personnel. The criminals mask their telephone number on caller ID by showing the DEA Registration Support 800 number. Please be aware … [Read more...] about DEA Registrants Beware!

  The Proposed Rule was published on Friday, March 29, 20 and is available here.   The proposed rule is designed to help employers who provide more perks to employees instead of raises in amounts of salaries.   The existing "regular rate" rules, which have not been updated in 50 years discourage the practice: “Under current rules, employers are discouraged from offering more perks to their employees, as those perks may be vaguely defined in calculating an employees’ regular rate of … [Read more...] about DOL Proposes New Rule Regarding Calculation of Overtime Pay Rates