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Fifty-eight people have been charged with engaging in healthcare fraud schemes that centered on the illegal distribution of more than 6 million opioid pills across Texas...Some 16 medical professionals, including six doctors and seven pharmacists, were charged in the schemes, which featured one pharmacy in Houston that illegally dispensed more than 760,000 pills from March 2018 to September 2019…The schemes in Texas entailed Medicare fraud that resulted in more than $66 million in losses...They also included $158 million in fraudulent claims for compound creams and $23 million in tax evasion...Federal authorities have frozen $60 million in assets of the people accused...READ MORE

Certain ranitidine medications used to treat heartburn—including some products sold under the brand-name Zantac—contain low levels of a nitrosamine impurity linked with cancer…The contaminant, N-nitrosodimethylamine (NDMA), is classified as a probable human carcinogen...The FDA has been investigating NDMA and other nitrosamine impurities in blood pressure and heart failure medicines (angiotensin II receptor blockers)...The FDA has recommended numerous ARB recalls as it discovered unacceptable levels of nitrosamines...NDMA, a known environmental contaminant, is found in water, meats, dairy products, and vegetables...The FDA is investigating the source of the ranitidine impurity. The agency pledged to “take appropriate measures based on the results of the ongoing investigation.”...READ MORE

The U.S. Department of Justice examined using fentanyl in lethal injections as it prepared last year to resume executing condemned prisoners…The department revealed it had contemplated using the drug in a court filing last month, which has not been previously reported...In the end, it decided against adopting the drug for executions. Attorney General William Barr announced...his department instead would use pentobarbital...when it resumes federal executions later this year, ending a de facto moratorium on the punishment…READ MORE

Laura Joszt, Managing Editor at The American Journal of Managed Care. Welcome to This Week in Managed Care from the Managed Markets News Network

Four people have been charged in a $99 million pharmacy fraud scheme...the defunct New York and New Jersey pharmacy group Prime Aid Pharmacies had been charged in a scheme that involved paying kickbacks to physicians and falsifying documents to fraudulently bill for medications that were not dispensed to patients...Prime Aid was able to secure network agreements with several pharmacy benefit managers that allowed it to earn reimbursements from both federal and private payers... Prime Aid also bribed physicians by paying an employee to work in the doctors' offices...the company received $65 million in reimbursements for drugs that they not only failed to provide to patients but that they never stocked or ordered...READ MORE

Nevada regulators are investigating marijuana testing laboratories to figure out how cannabis with exceedingly high levels of yeast and mold made it to store shelves, as well as for possibly doctoring THC levels to make cannabis products appear more potent to consumers...the state sent out a notice that several batches of marijuana flower and pre-rolls showed levels of yeast and mold that exceeded the state’s allowable limit after a secondary test. A follow-up test conducted by the state’s Department of Agriculture found that some of the products had yeast and mold levels of 390,000 colony-forming units per gram, which is nearly 40 times higher than the state’s legal threshold of 10,000 cfu/g...READ MORE

Purdue Pharma...filed for bankruptcy...days after reaching a tentative settlement with many of the state and local governments suing it…The filing was anticipated before and after the tentative deal, which could be worth up to $12 billion over time, was struck..."This settlement framework avoids wasting hundreds of millions of dollars and years on protracted litigation," Steve Miller, chairman of Purdue's board of directors, said in a statement, "and instead will provide billions of dollars and critical resources to communities across the country trying to cope with the opioid crisis. We will continue to work with state attorneys general and other plaintiff representatives to finalize and implement this agreement as quickly as possible."...READ MORE

With Purdue Pharma agreeing to settle with dozens of cities and states for a record-setting $12 billion, more opioid settlements could be on the way. But Purdue's agreement doesn't mean all the defendants are willing to go to the negotiating table quietly…Defendants in a Cleveland multidistrict litigation have gone so far as to attack the judge in charge of the case. In a...motion, retailers and distributors—but no drugmakers—demanded the removal of Judge Dan Polster for pushing a settlement. The absence of a pharma company there could show opioid makers are looking for deals rather than continuing to spar it out...READ MORE

...Healthcare for Missouri’s efforts to put the issue of Medicaid expansion on the 2020 ballot has raised more than $1.3 million to start the campaign…The campaign is drawing support from those in the healthcare community...Some within the healthcare community in Nevada are also eager to get the question to Missouri’s voters. Regional Hospital Controller Dana White explained that NRMC (Nevada Regional Medical Center) is a Disproportionate Share Hospital (DSH). “What that means is that we have a disproportionate share of self-pay, Medicare and Medicaid patients compared to other hospitals.” The hospital derives 75 percent of their revenue from those three sources. “I’m not an expert on Medicaid expansion, but I do know that it would help our hospital.”...Medicaid expansion would help them to stay healthy and be productive member of the community. That’s not specific to the hospital, that’s specific to the community as a whole.”...READ MORE

The CMS administrator views her work as public service, aims to put patients in the center of the healthcare decision-making process, and hopes to curb healthcare costs...Verma, a daughter of immigrants from India, says she views her work as 'giving back to this country that has given so much to me.'...Verma emphasizes consumer empowerment and transparent competition as central parts of the solution to the U.S. healthcare system's cost problem…READ MORE