Becker's Spine Review

January Issue of Becker's Spine Review 2019

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33 HEALTHCARE NEWS Healthcare accounted for bigger portion of 2018 DOJ false claims recoveries By Molly Gamble O f the $2.8 billion the Department of Justice recovered from False Claims Act cases in 2018, $2.5 billion in- volved the healthcare industry, according to the department's year-end recap. In 2017 the department recovered $3.7 billion in False Claims Act settlements and judgments, with $2.4 billion involving the healthcare industry. e largest 2018 healthcare-related recoveries stem from the drug and medical device industry, including a $582 million federal settlement paid by AmerisourceBergen Corporation. e pay- ment resolved allegations that the Chesterbrook, Pa.-based drug wholesaler illegally distributed adulterated and misbranded drugs, including sy- ringes for cancer patients, and caused numerous false claims to be submitted to Medicaid for un- approved, defective or compromised new drugs. Several substantial 2018 recoveries involve healthcare providers, including the $270 mil- lion payment from HealthCare Partners Hold- ings, doing business as DaVita Medical Hold- ings. e payment resolved False Claims Act liability for providing incorrect diagnosis codes that caused its Medicare Advantage Organiza- tions to receive inflated Medicare payments. Also worth noting is the case involving for- mer Naples, Fla.-based hospital chain Health Management Associates, which paid over $216 million in 2018 to resolve civil allegations that it billed government healthcare programs for costly inpatient services that should have been billed as observation or outpatient services, paid illegal remuneration to physicians in return for patient referrals to HMA hospitals and inflated claims for emergency department facility fees. is marks the ninth consecutive year that the DOJ's civil healthcare fraud settlements and judgments exceed $2 billion. Recoveries in the $2.5 billion total reflect only federal losses, but the DOJ was instrumental in recovering addi- tional millions for state Medicaid programs in many cases. n Walmart looks to add health clinics in its parking lots By Ayla Ellison W almart stores in several states are transforming extra parking lot space into "town centers," some of which could include health clinics, according to Business Insider. "The Walmart Town Center concept is an exciting approach to how we serve our customers by moving beyond the store's four walls and reimagining how we use our unique assets — our existing stores and the surrounding land — to transform how customers experience Walmart," a Walmart spokes- person told Business Insider. The Atlanta Business Chronicle reported that Walmart is evaluating whether to add health clinics in some of the new "town centers." "We envision a more robust and dynamic shopping experience that com- bines entertainment venues, curated local food vendors, health and fitness services as well as recreational opportunities in a way that connects and en- gages with the community," a Walmart spokesperson told Business Insider. Walmart has established its position as a one-stop shop, but it may be rede- fining what that means by surrounding its stores with a variety of comple- mentary tenants, according to the report. n 9 physician specialties see jump in compensation By Megan Knowles P hysicians in nine specialties saw increases in total cash compensation from 2017 to 2018, according to a survey from SullivanCotter. The survey includes data on nearly 167,000 individual physicians and advanced practice providers, with nearly 750 participating hospitals, health systems and medical groups. Reported total cash compensation generally increased from 2017-18, averaging 1 percent to 4 percent. Out of 10 specialties listed, surgery (general) was the only specialty that did not see an increase in total cash compensation. Here is the percent change from 2017-18 in total cash compensation for the nine other specialties in the survey: 1. Cardiology (general): 4.4 percent increase 2. Emergency medicine: 4.3 per- cent increase 3. Pediatrics (general): 3.7 percent increase 4. Orthopedic surgery (general): 3.2 percent increase 5. Hospitalist: 2.2 percent increase 6. Internal medicine: 2.1 percent in- crease 7. Family medicine: 2 percent 8. Psychiatry (general): 1.4 percent increase 9. Obstetrics and gynecology: 1.4 percent increase n

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