Fort Worth-based Healthpoint to Pay Up to $48 Million to Settle Fraud Case

Fort Worth-based Healthpoint Ltd., an operating company of DFB Pharmaceuticals, also based in Fort Worth. will pay up to $48 million to settle allegations that it fraudulently submitted claims to Medicare and Medicaid for an skin-ointment not approved by the FDA, according to the Department of Justice. To absolve the claim, Healthpoint and DFB have agreed to pay $28 million, plus another $20 million if there is a change in ownership of either concern in the next three years. The terms could complicate Smith & Nephew’s planned acquisition of Healthpoint for $782 million, announced late last month. At the moment, the… Full Story

Texas Insurers Cut Individual Market Overhead by 10 Percent

Insurance companies reduced administrative expenses and profits in the Texas individual health insurance market by more than 10 percent to meet the medical loss ratio (MLR) requirements under the Affordable Care Act (ACA), according to an analysis released by the Commonwealth Fund. To meet those requirements, companies cut $76 in administrative expenses and $109 in profits per individual policyholder in 2010-2011, the report said. The average overhead reduction was fourth largest decrease among U.S. states. The $185 total reduction is nearly identical to the $187 average rebate paid to Texas families in August because of the MLR requirement. Texans received nearly… Full Story

Morning Rounds (12.06.12)

This year’s national meningitis outbreak has sparked proposed legislation that would increase FDA oversight of pharmaceutical compounders.

U.S. Department of Justice recovered more than $3 billion from healthcare fraud cases in 2012—an all-time record.

The IRS has released details on new medical device tax — one that industry groups is lobbying lawmakers to repeal.

Medical interns are more alert when given protected “power nap” periods, according to a study published in The Journal of American Medicine.

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Morning Rounds (12.05.12)

A Houston-based hospital company is entering the Dallas market by acquiring Oak Cliff’s South Hampton Community Hospital in a $30 million deal.

Dallas-based AT&T has released its list of the top five healthcare IT trends for 2013.

The Government Accountability Office says variances in Medicaid expenses in two different data sets leave billions of dollars in expenditures unexplained.

Nursing is the country’s No. 1 trusted profession, according to a new Gallup poll. Overall, healthcare professions occupy three of the survey’s top four spots.

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UTD’s Specialized Master’s Program Grooms UTSW, THR Physicians and Managers for Senior Leadership Roles

This weekend, two dozen UT Southwestern managers and physicians will become the inaugural graduates of a custom-made healthcare management master’s degree program. The Healthcare Organization Leadership Program was designed and administered by the University of Texas at Dallas. The goal of the degree, called Master of Science in Management and Administrative Services, with a concentration in healthcare organization leadership, is to educate budding healthcare leaders on the fundamentals of finance and management. The program has blossomed into a partnership between the academic medical center and Texas Health Resources (THR). “We recognized that if we are going to deal with health… Full Story

Morning Rounds (12.04.12)

Fitch Ratings has come out with a forecast that predicts low single-digit growth for most healthcare companies in 2013.

The Obama Administration aims to fund health insurance exchanges in Texas, and other states that don’t opt to set up their own, through fees paid by participating insurers.

Should human genes be patented? The U.S. Supreme Court will take up the matter in a case that has broad consequences for the future of gene-based medicine

Dallas-based Tenet Healthcare Corp.’s quest to acquire a California hospital could drag on until January. Full Story

Humana Expands Relationship with Baylor and its New ACO

Humana’s Medicare Advantage health plan members will have broad in-network access to services provided by Baylor Health Care System beginning Dec. 15, 2012, in a new deal struck between the two parties. The agreement covers inpatient, outpatient, and emergency services provided by Baylor in Dallas, Tarrant, Denton, and Ellis counties. Seniors and other eligible Medicare beneficiaries who enroll in a Humana Medicare Advantage HMO or PPO plan during the annual election period ending Dec. 7, 2012, will have in-network benefits during the 2013 plan year. Enrollees in Humana’s other commercial and individual plans already have such access. According to a… Full Story

Texas Preterm Birth Rate Drops for Fifth Straight Year

Texas’ rate of preterm birth has stayed the same or dropped for the fifth straight year, according an analysis by the March of Dimes. But it’s still higher than the national average. The state’s rate fell from 13.7 percent in 2006 to 12.8 percent in 2011. Nationally, the preterm birth rate—the percentage of births prior to 37 weeks—dropped to 11.7 percent, the lowest in a decade. The U.S. preterm birth rate peaked in 2006 at 12.8 percent, after rising steadily for more than two decades, according to the National Center for Health Statistics. Preterm birth is the leading cause of newborn… Full Story

Morning Rounds (12.03.12)

Parkland Health & Hospital System says it has completed 90 percent of its corrective action plan items.

Former Nebraska governor and U.S. senator Bob Kerrey has rejoined the board of Tenet Healthcare Corp.

Dallas-based Cornerstone Healthcare Group will break ground on a long-term, acute-care hospital Dec. 4 in Round Rock.

Despite widespread stress, just 3 percent of primary care office visits involve stress management counseling, the Archives of Internal Medicine reports. Full Story

AMA: Dallas and Fort Worth Not “Highly Concentrated” Insurance Markets

About 70 percent of U.S. metropolitan areas lack sufficient competition among insurers, according to a report by The American Medical Association. The Dallas and Fort Worth metropolitan areas are not among them. The AMA analyzed 385 metropolitan statistical areas (MSAs) and defined “highly concentrated” insurance markets as having a Herfindahl-Hirschman Index (HHI) score greater than 2500. The index, named after two economists, is widely used in competition and antitrust law. Dallas-Plano-Irving had an HHI of 2300; Fort Worth-Arlington was 2040. According to the report, 89 percent of MSAs had at least one insurer with a commercial market share of at… Full Story