A federal judge Friday ruled in favor of UnitedHealth Group by tossing out a federal rule that required Medicare Advantage insurers, like UnitedHealth, to give back payments based on verified diagnosis codes in a medical record even though the traditional Medicare program relies on unaudited codes for payment.
Why it matters: The decision is a huge win for Medicare Advantage companies. It could affect other pending overbilling cases and how the federal government audits the industry that has a track record of inflating patient medical codes. Go deeper: Read more from Modern Healthcare and Fierce Healthcare.
Richard Sackler, whose family and company made billions from the sale of highly addictive opioid painkillers, has now patented a new and potentially lucrative treatment for opioid addiction, the Financial Times reports.
Why it matters: More than 200,000 people have died from prescription opioid overdoses since 1999. And Purdue Pharma, which the Sackler family owns privately, has become a poster child for the opioid crisis because of the way it aggressively marketed OxyContin despite rampant abuse of that drug.
The Senate will vote next week on its version of an omnibus bill to address the opioid crisis, Sen. Lamar Alexander, chairman of the health committee, announced last night.
What's next: The House passed its own opioids package in June. There are a lot of easy consensus items in both bills, but the two chambers will still have to reconcile differing details and potentially thorny issues like funding levels and Medicaid coverage.
