July 12, 2012

OIG - Glaxo Settlement

OIG reports that GlaxoSmithKline LLC (GSK) has agreed to plead guilty and pay a whopping $3 billion "to resolve its criminal and civil liability arising from the company's unlawful promotion of certain prescription drugs, its failure to report certain safety data, and its civil liability for alleged false price reporting practices".  The press release references the full announcement by the Department of Justice detailing the allegations and settlement, which is available here.

To ensure that the massive Glaxo settlement does not distract from the fact that government agencies are committed to rooting out fraud on all levels, Deputy Attorney General James M. Cole offered the following statement in the press release: "At every level, we are determined to stop practices that jeopardize patients' health, harm taxpayers, and violate the public trust - and this historic action is a clear warning to any company that chooses to break the law."  If you are targeted remember "in-office investigation" procedure, and, be sure to train your staff preventatively. 

Proposed Medicare PCP Pay Increase

Good news for primary care providers - CMS has issued a proposed rule on July 6, 2012 that would see increased payments to family phyisicians of around 7% and to other primary care practitioners of 3-5%.  CMS is proposing to pay for care required in order to transition a patient back to the community after their discharge from a hospital or nursing facility.  Under the proposal, CMS would make a separate payment to the patient's community physician or practitioner to coordinate care for 30 days. 

Public comment for the proposed rule is being sought on how the range of services provided by community physicians and practitioners may be better recognized by Medicare, which poses a great opportunity for providers to illustrate the services they provide to their patients.  See here for more information. 

Office of Medicare Inspector General Compliance Alert

OMIG is at it again, issuing additional compliance alerts notifying providers of the Compliance Requirements and their obligation to certify.  See here.   For those providers who qualify, ensuring compliance now and certifying, may just save you later.  To view our compliance solutions, visit our website. 


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