October 17, 2016

Country's biggest nursing home pharmacy pays big kickbacks fine



Omnicare, a giant nationwide specialty pharmacy whose South Florida outlet delivers medicines to 150 nursing homes and assisted-living facilities in the region, has agreed to pay a $28 million fine for taking kickbacks for recommending an epilepsy drug to its customers

While the drug Depakote's FDA-approved purpose is to treat seizures, it's off-brand sales have soared with Abbott Laboratories, the medicine's Chicago-based manufacturer, promoting it to control aggression in elderly patients with dementia.

The $28 million settlement, announced Monday by the Justice Department, came almost four years after the government sued Omnicare Inc. for accepting millions of dollars in kickbacks from Abbott Laboratories for promoting the use of Depakote.

"Elderly nursing home residents suffering from dementia are among our nation's most vulnerable patient populations," Deputy Assistant Attorney General Joyce R. Branda said in filing the December 2010 suit. "Kickbacks to consulting pharmacists compromise their independence and undermine their role in protecting nursing home residents from the use of unnecessary drugs."

In a separate lawsuit, Abbot Laboratories in 2012 agreed to pay DOJ a much larger fine, $1.2 billion, for having misbranded Depakota.

Omnicare, purchased least year by CVS Health,  has 160 locations throughout the country, including six in Florida. Its Weston branch serves 150 nursing homes and assisted living facilities throughout South Florida.

In an earlier settlement with DOJ, Omnicare agreed in 2012 to pay $50 million to resolve claims that it had improperly dispensed controlled substances.

Photo credit: Scott Eells, Bloomberg







September 29, 2016

President Obama to give health care speech Wednesday in Tampa

via @learyreports

WASHINGTON - President Barack Obama will deliver a speech on the Affordable Care Act on Wednesday at University of South Florida in Tampa, the White House said.


"Located in Hillsborough County, which has a strong health care system, USF offers a diverse set of training programs for health professions and has led efforts to sign up people for health insurance," the White House said. "Further details about the President's travel to Florida will be made available in the coming days."

It's unclear whether Obama will do another event for Hillary Clinton, though he is expected to hit the road on her behalf in October.

September 21, 2016

Liz Dudek, top health care official, retires after 40 years with state


Liz Dudek, one of the longest-serving agency heads under Gov. Rick Scott, is retiring as secretary of the Agency for Health Care Administration, the governor's office announced Wednesday.

Dudek, who earns $141,000, is responsible for the agency that manages Medicaid in Florida. Her leave is official Oct. 3.

Deputy Secretary of Medicaid Justin Senior has been appointed interim secretary of the agency.

Dudek, of Tallahassee, has led AHCA since 2011 when Scott took office. But her tenure with the state reaches back more than 40 years.

"Under her leadership, we have worked to make hospitals more transparent and accomplished historic Medicaid reform," Scott said in a statement. "She helped champion quality health services for children in our state and worked hard on our Commission on Healthcare and Hospital Funding where she fought to protect patients from being price gouged at hospitals."

She previously was bureau chief of health facility compliance and assistant deputy secretary of managed care and health quality for AHCA.

Last year, after lawmakers reached stalemate over expanding Medicaid, Scott named Dudek the co-chairman of the Commission on Health Care and Hospital Funding.

Dudek's agency has been under scrutiny in recent years for its treatment of abortion clinics, and both she and Senior have been at the front lines of major political battles in the Florida Legislature over Medicaid expansion and health care reforms.

Still, even critics of the Scott administration's health care agenda laud Dudek's leadership.

"She was always really professional to work with," said House Democratic Leader Mark Pafford, D-West Palm Beach, CEO of pro-Medicaid expansion group Florida CHAIN. "There aren't very many people at all that I have tremendous respect for and admiration, but Liz is one of those few people."

Correction: An earlier version of this post incorrectly said AHCA is responsible for Medicare in Florida.

December 22, 2015

PAC ad highlights Marco Rubio's efforts to end Obamacare

A Super PAC supporting U.S. Sen. Marco Rubio released a TV ad today that highlights his efforts to end Obamacare.

The Conservative Solutions' ad will run on TV in Iowa and New Hampshire.

The ad states: "For all the Republican talk about dismantling the Affordable Care Act, one Republican presidential hopeful has actually done something…“Marco Rubio conceived and pushed a plan that will all but kill ObamaCare.”

It's not entirely clear from the ad, but it is a reference to Rubio's efforts last year related to something called "risk corridors" in the Affordable Care Act. In December, PolitiFact Florida fact-checked a tweet by Rubio who said "Last year, I stopped an Obamacare bailout and saved taxpayers $2.5 billion."

He was referring to risk corridors, which faced a $2.5 billion shortfall for 2014. Rubio, whose efforts to repeal risk corridors have so far failed, helped persuade Congress last year to prevent Health and Human Services from being able to cover the difference with money from its own budget. But experts said calling the program a bailout is not accurate and that he didn't necessarily save money in the long run. PolitiFact Florida rated his claim Mostly False.  


December 17, 2015

Miami health insurer blames layoffs on risk-corridor limits pushed by Marco Rubio

via @dchangmiami

A Coral Gables-based health insurance company and dozens of its employees are the latest casualties of a Republican-led legislative gambit in 2014 to undermine the Affordable Care Act — a maneuver for which presidential hopeful and U.S. Sen. Marco Rubio of Florida has taken credit on the campaign trail.

Preferred Medical Plan filed notice on Wednesday that the private insurance company intends to lay off 162 employees in February, according to the Florida Department of Economic Opportunity.

The company will remain in business, said James Card, a spokesman. But Preferred Medical will cover a much smaller number of Floridians — in large part because of a significant reduction in payments that the company expected to receive under the health law.

“Preferred Medical was prohibited from participating on the 2016 [ACA] exchange,” Card said in a written statement.

The reason: the federal Centers for Medicare and Medicaid Services or CMS could not pay the health insurer what was promised in 2010 under the so-called Risk Corridor program, a risk-sharing arrangement that Rubio calls a taxpayer “bailout” of insurance companies.

Following Wednesday’s release of an appropriations bill that includes a measure to once again restrict payments to insurers in 2016, Rubio issued a press release that read, in part: “ObamaCare’s bailout provision has nothing to do with helping people access health insurance, but it has everything to do with how big businesses in this country game big government to increase their profits, and how big government games big businesses to increase government’s reach into our lives.”

More here.

November 18, 2015

HHS secretary visits Miami to promote Obamacare

via @dchangmiami

With more than a million Floridians signed up for coverage through the Affordable Care Act’s insurance exchange — and nearly as many still uninsured but eligible for some type of plan in 2015 — Health and Human Services Secretary Sylvia Burwell visited Miami on Wednesday to make a hard sell for people to enroll.

She toured an enrollment center at Miami Dade College’s Wolfson Campus downtown, met privately with South Florida healthcare leaders and held a press conference where she introduced a Miami small business owner who pays $75 a month for coverage through the exchange.

Burwell also repeated slogans about the “affordability” of health plans sold on the exchange and trumpeted the “simplicity and ease” of enrollment with new user-friendly features, such as an “out-of-pocket cost estimator” tool that debuted this year on healthcare.gov to help consumers estimate their plan deductibles, co-payments and other expenses.

About 1 million people nationwide — about one third of whom are new consumers — have selected a plan during the first two weeks of open enrollment, which began Nov. 1 and runs through Jan. 31, though people have to pick a plan by Dec. 15 to have coverage beginning on Jan. 1.

More here.

October 13, 2015

Jeb Bush to outline plan to replace Obamacare

via @learyreports

On Tuesday in New Hampshire, Jeb Bush will outline a plan to replace Obamacare.

Background from his campaign:

I. Promote innovation in health care

Health care costs grow faster than any other sector of the economy and innovation lags. Why? Washington over-regulation in health care creates high barriers to entry, adds excessive costs, fosters excessive complexity and impedes innovation. Governor Bush will:

• Modernize the Food and Drug Administration’s regulatory morass and increase funding and accountability at the National Institutes of Health

• Promote private sector leadership of health information technology adoption and enable better access to patient de-identified Medicare and Medicaid claims data

• Establish a comprehensive review of regulatory barriers to health innovation

Continue reading "Jeb Bush to outline plan to replace Obamacare" »

September 11, 2015

Kathy Castor asks feds to intervene in Florida's failure to cover poor and disabled kids

via @Marbinius

U.S. Rep. Kathy Castor is asking federal health administrators to investigate Florida’s “outrageous and miserable history” of denying adequate healthcare to impoverished and disabled children, saying the state has deliberately ignored a judge’s ruling that Florida’s insurer for the needy is systematically violating federal law.

In a letter Thursday, Castor called upon Sylvia Burwell, the secretary of the U.S. Department of Health and Human Services, to “exercise [her] oversight and enforcement authority to ensure Florida children receive the care required under the law.”

By sending the missive, Castor, a Tampa Democrat, is wading into a dispute between state health administrators and doctors for impoverished children that simmered for a decade before reaching a boiling point last year. On the last day of December 2014, U.S. Circuit Judge Adalberto Jordan declared Florida's healthcare system for needy and disabled children to be in violation of several federal laws. Jordan’s ruling was a milestone in a lawsuit by pediatricians and several families that had been filed 10 years earlier.

Florida’s spending for the healthcare of children in Medicaid, the state’s insurer for the needy, is so inadequate, Jordan wrote in a 153-page ruling, that most pediatricians and specialists have been driven from the program. As a consequence, the judge wrote, poor and disabled children often endure long waits for an appointment, or travel hours to a population center to see a doctor.

More here.

August 27, 2015

Florida regulator says Obamacare premiums will rise 9.5% in 2016

via @dchangmiami

Health insurance premiums for Floridians who buy their own plans will rise 9.5 percent on average for 2016, though some consumers will pay less for their coverage than they did this year, state insurance regulators reported Wednesday.

A total of 19 health insurance companies submitted rate filings to Florida’s Office of Insurance Regulation, which this year regained the authority to deny rate increases for health plans sold on the Affordable Care Act’s insurance exchange at HealthCare.gov.

Average rate changes for 2016 plans sold on the ACA exchange will range from a decrease of nearly 10 percent for some plans, to an increase of as much as 16 percent for others.

Rate increases could have been higher, though, if not for the return of prior-approval authority for the Office of Insurance Regulation this year. A 2013 state law barred the state agency from regulating rates for ACA exchange plans, but that prohibition expired in March.

As a result, Florida regulators denied proposed rate increases for more than half of the issuers in the state for 2016. The majority of health plans received approval for single-digit increases, and four will decrease their rates from 2015.

More here.

August 24, 2015

Florida lawmakers featured in anti-Medicaid expansion ads

Several Tampa Bay area legislators are among those featured prominently in a new TV and digital ad by Americans for Prosperity, "thanking" them for blocking Medicaid expansion during the 2015 session.

AFP, a conservative advocacy group backed by the Koch brothers, says in a release that "the two-week long TV effort will feature TV, digital and mail to educate Floridians about the 72 legislators who stood up for taxpayers and patients against special interests who pushed to bring Obama’s Medicaid expansion to the Sunshine State."

AFP says five different versions of its 30-second ads are airing across Florida, including the one below.