Free Health Law Webinar–Internal and Government Investigation Strategies

It’s your last chance to register for the second free webinar in Wolters Kluwer Legal & Regulatory, U.S.’s four-part webinar series in partnership with Alston & Bird focusing on best practices for handling internal and external healthcare fraud and False Claims Act investigations.

“Internal and Government Investigation Strategies”, will discuss how companies can conduct cohesive internal investigations, what the government expects organizations to do and the investigative techniques that the government uses. To register, visit the link below:
Internal and Government Investigation Strategies 
Tuesday, December 4, 2018 at 2 PM EST
Moderator: Frank Sheeder, Partner at Alston & Bird
Featured speakers: Wade Miller, Partner, and Matt Dowell, Senior Associate at Alston & Bird

For information on the full webinar series, visit http://health.wolterskluwerlb.com/2018/10/wk-announces-free-webinar-series-on-healthcare-investigations/

U.S. pays nearly twice as much for drugs compared to other countries

A recent HHS analysis revealed that prices charged by drug manufacturers to wholesalers and distributors in the United States are 1.8 times higher than in other countries for the top drugs by total expenditures separately paid under Medicare Part B. U.S. prices were higher for most of the drugs included in the analysis, and U.S. prices were more likely to be the highest prices paid among the countries in the study (ASPE Report, October 25, 2018).

Medicare Part B

Drugs typically administered to patients by healthcare practitioners are covered and paid under Medicare Part B, which is part of the fee for service traditional Medicare benefit. Under Part B, providers buy and bill for these drugs. Medicare pays suppliers and providers based upon the Average Sales Price (ASP) for each product, as reported by manufacturers to CMS. Physician offices that buy and bill Part B drugs are paid 106 percent of the drug’s ASP, and hospitals are reimbursed either at 106 percent or 77.5 percent of ASP, depending on the hospital outpatient department’s participation in a safety net drug pricing program. Spending on Part B drugs has doubled since 2006.

The analysis and results

Data was compiled on the top drugs based on total Medicare reimbursement to either physician offices, hospital outpatient departments, or overall under Medicare Part B in 2016. Countries included in the analysis included: the United States, Austria, Belgium, Canada, Czech Republic, Finland, France, Germany, Greece, Ireland, Italy, Japan, Portugal, Slovakia, Spain, Sweden, and the United Kingdom. The analysis identified thirty two Medicare Part B drugs among the top twenty drugs in spending for each setting. These thirty two drugs accounted for $18 billion in spending, out of a total $27 billion on Part B drugs across these settings. The main analysis reports on twenty seven Part B Drugs.

Across the twenty seven drugs in the study, the U.S. ex-manufacturer prices were 1.8 times than average international ex-manufacturer price. There was not any one country that consistently had the highest or lowest prices compared to the U.S. for twenty of the drug products; U.S. prices exceeded the average international price by more than twenty percent. In addition, for nineteen of the twenty seven products the U.S. prices were higher than any other country. Excluding the U.S., Germany and Canada had the highest prices for six drugs and Japan for five drugs. France and the United Kingdom had the lowest prices for four drug products. Japan, Sweden and Slovakia had the lowest prices for three drug products each. Finally, the analysis calculated that the Medicare program and its beneficiaries spent an additional $8.1 billion (47 percent more) on these twenty seven products that it would have, if payments based upon ASP were scaled by the international price ratios.

Overall, prices and reimbursement rates for Part B drugs are significantly higher for the U.S. providers than purchasers outside the U.S., except for a few outlier cases. The amount by which U.S. prices exceeded those of international comparators varied significantly by product, and there was no clear pattern as to which countries were consistently paying lower prices. The analysis suggests that Medicare Part B could achieve significant savings if prices in the U.S. were similar to those of other large market based economies.

Free Health Law Webinar–Steps to Take When a Fraud, Waste, or Abuse Issue is Discovered

It’s your last chance to register for the first free webinar in Wolters Kluwer Legal & Regulatory, U.S.’s four-part webinar series in partnership with Alston & Bird focusing on best practices for handling internal and external healthcare fraud and False Claims Act investigations.

“Steps to Take When a Fraud, Waste, or Abuse Issue Is Discovered”, will cover the essential elements of a comprehensive investigation plan that prudent organizations should develop as a first step when fraud, waste, or abuse is discovered. To register, visit the link below:
Steps to Take When a Fraud, Waste or Abuse Issue is Discovered
Thursday, November 1, 2018 at 3 PM EST
Moderator: Frank Sheeder, Partner at Alston & Bird
Featured speakers: Jason Popp, Partner, and Brad Smyer, Senior Associate at Alston & Bird

For information on the full webinar series, visit http://health.wolterskluwerlb.com/2018/10/wk-announces-free-webinar-series-on-healthcare-investigations/

WK Announces Free Webinar Series on Healthcare Investigations

Wolters Kluwer Legal & Regulatory U.S. announced that registration is open for a four-part webinar series in partnership with Alston & Bird focusing on best practices for handling internal and external healthcare fraud and False Claims Act investigations. This educational activity has been submitted to HCCA and is currently pending their review for continuing education.

Each webinar in the series will feature Alston & Bird attorneys covering topics such as handling fraud, waste, and abuse issues, dealing with internal and government investigations, and managing complainants and whistleblowers. These discussions will be based on real-life scenarios that participants will receive in advance, and will offer practical, actionable approaches to the most confounding challenges. The webinars will also include a demonstration of how compliance professionals can leverage Cheetah™, Wolters Kluwer’s intuitive legal research platform, to assist in mitigating risks and issues.

“Healthcare industry stakeholders need to be aware of the potential legal and regulatory compliance risks, costs, and disruptions that can potentially arise in an organization,” said Kristen Kaplan, Sr. Health Law Product Manager for Wolters Kluwer Legal & Regulatory U.S. “This webinar series will offer practical and actionable approaches to mitigating these issues.”

“Healthcare organizations face a challenging legal, regulatory, and enforcement environment,” said Frank Sheeder, Partner at Alston & Bird and Co-Chair of its Healthcare Litigation Team.  “We are pleased to partner with Wolters Kluwer on this webinar series to share our experiences and help their in-house counsel, compliance professionals, and reimbursement teams to better serve their organizations.”

The first webinar in the series, “Steps to Take When a Fraud, Waste, or Abuse Issue Is Discovered”, will cover the essential elements of a comprehensive investigation plan that prudent organizations should develop as a first step when fraud, waste, or abuse is discovered. To register, visit the link below:
Steps to Take When a Fraud, Waste or Abuse Issue is Discovered
Thursday, November 1, 2018 at 3 PM EST
Moderator: Frank Sheeder, Partner at Alston & Bird
Featured speakers: Jason Popp, Partner, and Brad Smyer, Senior Associate at Alston & Bird

The second webinar, “Internal and Government Investigation Strategies”, will discuss how companies can conduct cohesive internal investigations, what the government expects organizations to do and the investigative techniques that the government uses. To register, visit the link below:
Internal and Government Investigation Strategies 
Tuesday, December 4, 2018 at 2 PM EST
Moderator: Frank Sheeder, Partner at Alston & Bird
Featured speakers: Wade Miller, Partner, and Matt Dowell, Senior Associate at Alston & Bird

The third webinar is titled “Dealing with the Government, Complainants, and Whistleblowers”. It will explore the external and internal adversaries organizations face and participants will hear from a former United States Attorney about best practices for contending with them. To register, visit the link below:
Dealing with the Government, Complainants, and Whistleblowers 
Thursday, January 10, 2019 at 2 PM EST
Moderator: Frank Sheeder, Partner at Alston & Bird
Featured speakers: Former US Attorney Thomas Walker and Meredith Kingsley, Partners at Alston & Bird

“Lessons Learned That We Hope Not to See Repeated” will discuss some of the most notorious investigation failures that have occurred in healthcare organizations, and the speakers will offer advice on how to avoid pitfalls. To register, visit the link below:
Lessons Learned that We Hope Not to See Repeated 
Wednesday, February 6, 2019 at 2 PM EST
Featured speakers: Frank Sheeder and Mitch Mitchelson, Partners at Alston & Bird

About Alston & Bird
Alston & Bird is a leading national and international law firm. The firm’s core practice areas are complex litigation, corporate, intellectual property and tax, with national industry practices that include healthcare, life sciences, financial services, technology, manufacturing, and energy. The firm has built a reputation as one of the country’s best employers, appearing on Fortune magazine’s “100 Best Companies to Work For” list for 19 consecutive years, an unprecedented accomplishment among law firms in the United States. The firm has offices in Atlanta, Beijing, Brussels, Charlotte, Dallas, Los Angeles, New York, Raleigh, San Francisco, Silicon Valley, and Washington, D.C.

For more information about Alston & Bird, visit www.alston.com, follow us on FacebookTwitter, and LinkedIn.

About Wolters Kluwer Legal & Regulatory U.S.
Wolters Kluwer Legal & Regulatory U.S. is part of Wolters Kluwer N.V. (AEX: WKL), a global leader in information, software solutions and services for professionals in the health, tax and accounting, risk and compliance, finance and legal sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services.

Wolters Kluwer reported 2017 annual revenues of €4.4 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

For more information about Wolters Kluwer Legal & Regulatory U.S., visit www.WoltersKluwerLR.com, follow us on FacebookTwitter and LinkedIn.