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CLINICAL ROLE -

Community/Retail
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Article

March 29, 2017

Trending News Today: Government Joins Fraud Lawsuit Against UnitedHealth Group

Author(s):

Laurie Toich, Assistant Editor

Top news of the day from across the healthcare landscape.

The Justice Department has recently joined a lawsuit that alleges UnitedHealth Group of fraud in their Medicare Advantage plans. According to Kaiser Health News, the insurer has been accused of making patients appear sicker than they actually are to gain a larger profit. It is speculated that fraud lawsuits against UnitedHealth could exceed $1 billion. However, UnitedHealth Group denies the allegations, and say they have complied with the rules.

GOP leaders are continuing the discussion about repealing and replacing the Affordable Care Act after their original bill failed to gain support from lawmakers. Revival efforts for the American Health Care Act (AHCA) may take a backseat to other issues, with Republican Senators saying they have other top priorities at this time, The New York Times reported. House Speaker Paul Ryan (R-WI) did not offer any details about the next version of the AHCA or any timeline, but he said it needed to come before insurers begin creating health plans for 2018.

Yesterday, the FDA approved dupilumab (Dupixent) injection for the treatment of patients with moderate-to-severe atopic dermatitis. The newly approved drug comes with a pricetag of $37,000 per year; however, the cost is still slightly lower than other biologic drugs for skin conditions, such as adalimumab (Humira) or entanercept (Enbrel). Instead of waiting, Sanofi and Regeneron negotiated the price and other details for the drug ahead of time to offset any potential concerns over the out-of-pocket costs for this breakthrough treatment, according to The New York Times.

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