News for Insurers
Top stories summarized by our editors
12/8/2017

People who have health insurance under the Affordable Care Act and don't re-enroll by the Dec. 15 deadline will be automatically enrolled in the same plan or a similar one. Experts say that could leave people with a more costly plan they don't want, and they might not have a chance to change it as they have in the past.

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Kaiser Health News
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ACA, health insurance
12/8/2017

Pfizer is launching a generic version of its blockbuster erectile dysfunction drug Viagra to hold market share as its patents expire.

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Pfizer, Viagra
12/8/2017

Medicaid rolls are likely to expand if Congress repeals the tax penalty on Americans who are not enrolled in an Affordable Care Act-compliant health plan, according to the Congressional Budget Office.

12/8/2017

The FDA requires some drugmakers to conduct safety and efficacy studies after drugs are approved, but 86% of the required studies were pending as of the end of fiscal 2016, 21% of the required status reports had not been filed and 12% of the status reports were filed late.

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FDA
12/8/2017

More than 2,000 immunotherapies for cancer are in drugmakers' pipelines, creating duplication and high demand for clinical trial participants.

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Reuters
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cancer
12/8/2017

A shrinking sign-up period, reduced marketing and outreach, and a 40% cut in funding to people who offer in-person assistance to individuals buying insurance has left young people, who often don't see the value in health insurance, with a range of challenges as they enter the market.

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Kaiser Health News
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health insurance
12/8/2017

Augustine Uche, a health care provider from Oklahoma City, Okla., is facing charges of Medicaid fraud and unlawful use of a computer to commit a criminal offense on allegations that he improperly billed the Oklahoma Health Care Authority for unprovided counseling services. Court records show Uche improperly billed over $34,000 to the program.

12/8/2017

Antoine Skaff, a dentist from Charleston, W. Va., was sentenced to five years in prison and three years of post-release supervision after pleading guilty to health care fraud earlier this year. Skaff, who also paid $2.2 million in a related civil settlement, submitted over $1.4 million worth of fraudulent claims to West Virginia Medicaid and state Medicaid Managed Care Organizations from January 2011 and August 2016, which resulted in $735,077 worth of improper payments, authorities say.

12/8/2017

Gloria Andrade, a social worker from Teaneck, N.J., was charged with Medicaid fraud, health care claims fraud and other crimes on allegations that she improperly billed Medicaid for mental health services she didn't provide for three years beginning Jan. 1, 2012. Andrade has a private practice and the charges are unrelated to her social services specialist position with Teaneck township, according to authorities.

12/8/2017

Brett Ford, a resident of Helena-West Helena, Ark., was ordered to pay $311.04 in restitution and $933.12 in fines after entering a no-contest plea to a single count of Medicaid fraud. An investigation found that Ford submitted fraudulent claims to Medicaid for services he didn't provide in August 2015.

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Brett Ford, Medicaid