U.S. DEFENSE DEPARTMENT CONTRACTS FOR APRIL 18, 2014

FROM:  U.S. DEFENSE DEPARTMENT 

CONTRACTS

DEFENSE LOGISTICS AGENCY

Delta Industries, East Granby, Conn., has been awarded a maximum $37,177,882 firm-fixed-price, indefinite-delivery/indefinite-quantity contract for turbine exhaust engine cases. This is a competitive acquisition, and one offer was received. This is a two-year base contract. Location of performance is Connecticut with a May 31, 2016 performance completion date. Using service is Air Force. Type of appropriation is fiscal 2014 defense working capital funds. The contracting activity is the Defense Logistics Agency Tinker Air Force Base, Okla., (SPRTA1-14-D-0009).

Golden State Medical Supply,* Camarillo, Calif., has been awarded a maximum $22,512,293 modification (P00054) exercising the fifth option period on a one-year base contract (SPM2D0-09-D-0001) with seven one-year option periods for various pharmaceutical supplies. This is a firm-fixed-price, indefinite-delivery/indefinite-quantity contract. Location of performance is California with an April 20, 2015 performance completion date. Using military services are Army, Navy, Air Force, and Marine Corps. Type of appropriation is fiscal 2014 warstopper funds. The contracting activity is the Defense Logistics Agency Troop Support, Philadelphia, Pa.

ARMY

Lockheed Martin Corp., Orlando, Fla., was awarded a $24,449,293 cost-plus-fixed-fee, sole-source contract to install a vehicle and dismounted exploitation radar (VADER) system and an aerial precision geolocation kit on a King Air 350ER aircraft. Fiscal 2013 research, development, testing and evaluation funds in the amount of $5,700,639 were obligated at the time of the award. Estimated completion date is March 18, 2015. One bid was solicited and one received. Work will be performed in Hagerstown and Linthicum Heights Md.; Greenville, Texas; and Fayetteville N.C. Army Contracting Command, Redstone Arsenal, Ala., is the contracting activity (W58RGZ-14-C-0040).
RSP Architects, Minneapolis, Minn., was awarded a $9,000,000 firm-fixed-price contract for architect and engineer services for the design, construction of various Air Force Reserve projects. Funding and work location will be determined with each order. Estimated completion date is April 18, 2019. Bids were solicited via the Internet with 32 received. U.S. Army Corps of Engineers, Louisville, Ky., is the contracting activity (W912QR-14-D-0008).

NAVY

General Dynamics Ordnance and Tactical Systems, Orlando, Fla., is being awarded a $9,248,770 modification to previously awarded contract (N00174-08-D-0021) for the procurement of the improved mechanical remote fuze disassembly kit (I-MRFDK ) production units, training, system maintenance and spare and depot level repair parts. The I-MRFDK is a portable ordnance inerting and disassembly system operated by explosive ordnance disposal technicians to safely inert fuzes used with projectiles, bombs, and other explosive ordnance. Work will be performed in Orlando, Fla., and is expected to be completed by September 2015. Contract funds will not be obligated at time of award and will not expire at the end of the current fiscal year. The Naval Surface Warfare Center, Indian Head Explosive Ordnance Disposal Technology Division, Indian Head, Md., is the contracting activity.

3 Phoenix Inc., Chantilly, Va., is being awarded a $7,263,632 modification to previously awarded contract (N00024-13-C-6264) to procure two TB-29A Inverted Passive Electrical Network (iPEN) Towed Array production representative units, associated spares and test equipment. iPEN leverages technology developed under Small Business Innovation Research Topic N04-138, “Real-time Data Fusion and Visualization Interface for Environmental Research Data.” iPEN telemetry acts as a data fusion point for the integration of towed array handling system sensor data. This technology is expected to provide significant improvement in reliability and operational availability of TB-29A towed arrays. Work will be performed in Wake Forest, N.C. (50 percent); Houston, Texas (25 percent); Hanover, Md. (15 percent); and Chantilly, Va. (10 percent), and is expected to be completed by August 2015. Fiscal 2011 and 2012 shipbuilding and conversion, Navy contract funds in the amount of $7,263,632 will be obligated at time of award and will not expire at the end of the current fiscal year. The Naval Sea Systems Command, Washington, D.C., is the contracting activity.

AIR FORCE

Rand and Jones Enterprises, Co., Inc., Buffalo, N.Y., has been awarded an $8,000,000 indefinite-delivery/indefinite-quantity contract for a Simplified Acquisition of Base Engineering Requirements contract for completion of minor, non-complex construction projects requiring minimum design. Typical projects involve a number of general construction disciplines including, but not limited to, plumbing, masonry, electrical, mechanical, architectural, painting, HVAC, and abatement. Work will be performed at Rome, Newport, and Stockbridge, N.Y., and is expected to be completed April 18, 2019. The ordering period concludes five years after the effective date of the contract. This award is the result of a competitive acquisition. The solicitation was conducted through Federal Business Opportunities, and two offers were received. Funding varies based on individual requirements but is primarily operations and maintenance, research and development, or Defense Finance and Accounting Service. Current fiscal year funding will be provided on individual orders. Air Force Research Laboratory Specialized Acquisition and Operational Contracting Branch, Rome N.Y., is the contracting activity (FA8751-14-D-0004).

TRICARE

Express Scripts Inc., St. Louis, Mo., is being awarded a $33,800,000 requirements-type contract with fixed unit prices, to provide pharmacy benefit management services to the Department of Defense TRICARE pharmacy program. The total cumulative face value of the contract, including the one year base period and seven one-year option periods, if exercised, for pharmacy benefit management services, and options for contract phase-out, is estimated at $5,364,684,318. The TRICARE Pharmacy Benefits Program offers pharmacy services through direct care pharmacy services at Military Treatment Facilities; retail network pharmacies; authorized retail non-network pharmacies; or delivery through the TRICARE Home Delivery/Mail Order Pharmacy. Retail pharmacy services are available in all 50 states and the District of Columbia, Guam, Puerto Rico, and the Virgin Islands. The contractor will perform pharmacy benefits management functions, including the following: perform claims adjudication, administer a retail pharmacy network, operate mail order pharmacy, provide clinical services for specialty pharmaceuticals, process direct member reimbursements for claims filled at retail network and non-network pharmacies, perform clinical reviews, and provide beneficiary and pharmacy support services. The contractor will also perform as a fiscal intermediary on behalf of DoD to pay for all authorized pharmaceuticals and supplies dispensed for eligible beneficiaries at retail pharmacies and transmit all claim information to the Pharmacy Data Transaction Service, the DoD designated data warehouse. This contract was competitively procured using the Best Value Tradeoff Source Selection process, with two offers received. Fiscal 2014 DoD operations and maintenance funding in the amount of $33,800,000 is being obligated at award. The Defense Health Agency, Aurora, Colo., is the contracting activity (HT9402-14-D-0002).

*Small Business

THIS YEARS FLU VACCINE EXPANDS PROTECTION

FROM:  U.S. DEFENSE DEPARTMENT 
New Vaccine Protects Against Additional Flu Strain
TRICARE Management Activity

FALLS CHURCH, Va., Sept. 26, 2013 - Each year, flu season affects millions of people. Flu season usually begins in October, so now is a great time to protect yourself and your family by getting vaccinated.

The flu shot is easy to get and inexpensive – often free – for TRICARE beneficiaries, and this year the flu vaccine offers even more protection.

Until now, seasonal flu vaccines have only protected against three strains of flu - two strains of influenza A, which usually causes more cases and more severe illness, and one of influenza B, which is less common but also circulates in multiple forms.

The new vaccines include protection against a second strain of influenza B, which experts expect will prevent the vast majority of type B infections.

The flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat and lungs. Symptoms include fever, cough, sore throat, stuffy nose, body aches, headaches and fatigue. According to the Centers for Disease Control and Prevention, the flu virus can be more serious for young children, older adults, pregnant women and people with medical conditions. It can cause mild to severe illness, and at times can lead to death.

TRICARE covers both the flu shot and flu mist. Beneficiaries may be able get their flu vaccine, at no cost, from a military treatment facility, hospital or from a pharmacist at one of the 45,000 network pharmacies that administer vaccines to TRICARE beneficiaries.

CDC officials also recommend steps to prevent the spread of germs, which can lead to the flu:

-- Avoid close contact with people who are sick;

-- Stay at home when sick;

-- Cover mouth and nose when coughing or sneezing;

-- Wash hands often with soap and water; and

-- Avoid touching eyes, nose or mouth.

CDC officials also recommend getting plenty of sleep, being physically active, managing stress, drinking plenty of fluids and eating nutritious food.

INSPECTOR GENERAL'S OFFICE DETERMINES PHARMACY HOME DELIVERY TO HAVE BENEFITS

FROM:  U.S. DEFENSE DEPARTMENT 
IG Finds Pharmacy Home Delivery Cost-Efficient, Safe
From a TRICARE Management Activity News Release

FALLS CHURCH, Va., Sept. 16, 2013 - Following an almost year-long study of the TRICARE Pharmacy Home Delivery program requested by members of Congress, the Defense Department inspector general's office has determined it is a cost-efficient way for beneficiaries to get their prescription medications, TRICARE Management Activity officials reported.

The inspector general's study found that the Home Delivery mail-order program saved the government 16.7 percent -- nearly $67 million -- in the third quarter of fiscal year 2012, officials said.

The audit compared what the government spent on prescription drugs through Home Delivery and what the cost would have been at retail pharmacies. Additionally, the TRICARE pharmacy contractor, Express Scripts, reported to the inspector general that Home Delivery offers a 99.99 percent prescription fill accuracy rate, high beneficiary satisfaction and improved patient outcomes.

"Although not surprised, we are certainly pleased at the results of the report," said Navy Rear Adm. Thomas J. McGinnis, chief of TRICARE pharmaceutical operations. "Home Delivery saves beneficiaries and the Department of Defense millions of dollars every year, and gives beneficiaries a safe and secure way to receive their prescription medications."

In June 2013, the 1.64 million prescriptions filled through Home Delivery represented a 17 percent increase in volume compared to the previous year, while retail prescription volume fell 10 percent, officials said.

When TRICARE beneficiaries use the Home Delivery pharmacy to fill maintenance medication prescriptions, they receive a 90-day supply through the mail and have no copayment for generic formulary medications and a $13 copay for brand-name formulary medications. At retail network pharmacies, beneficiaries pay $5 for a 30-day supply of generic formulary medications and $17 for brand name formulary medications.

TRICARE beneficiaries can sign up for Home Delivery online, by mail or by phone.

MEDICAL TESTING COMPANY WILL PAY $3.57 MILLION TO RESOLVE FALSE CLAIMS ACT ALLEGATIONS

FROM:  U.S. JUSTICE DEPARTMENT 
Tuesday, August 27, 2013

MRI Diagnostic Testing Company, Imagimed LLC, and Its Former Owners and Chief Radiologist to Pay $3.57 Million to Resolve False Claims Act Allegations
New York-based Imagimed LLC, the company’s former owners, William B. Wolf III and Dr. Timothy J. Greenan, and the company’s former chief radiologist, Dr. Steven Winter, will pay $3.57 million to resolve allegations that they submitted to federal healthcare programs false claims for magnetic resonance imaging (MRI) services, the Justice Department announced today.  Imagimed owns and operates fifteen MRI facilities, located primarily in New York state, under the name “Open MRI.”

 Allegedly, from July 1, 2001, through April 23, 2008, Imagimed, Greenan, Wolf and Winter submitted claims to Medicare, Medicaid and TRICARE for MRI scans performed with a contrast dye without the direct supervision of a qualified physician.  Since a potential adverse side effect of contrast dye is anaphylactic shock, federal regulations require that a physician supervise the administration of contrast dye when it is used for an MRI.  Also, allegedly, from July 1, 2005, to April 23, 2008, Imagimed, Greenan, Wolf and Winter submitted claims for services referred to Imagimed by physicians with whom Imagimed had improper financial relationships.  In exchange for these referrals, Imagimed entered into sham on-call arrangements, provided pre-authorization services without charge and provided various gifts to certain referring physicians, in violation of the Stark Law and the Anti-Kickback Statute.

 “The Department of Justice is committed to guarding against abuse of federal healthcare programs,” said Stuart F. Delery, Assistant Attorney General for the Civil Division.  “We will help protect patients’ health by ensuring doctors who submit claims to federal healthcare programs follow proper safety precautions at all times.”

U.S. Attorney for the Northern District of New York, Richard S. Hartunian said: “This case is an example of our commitment to using all of the remedies available, including civil actions under the False Claims Act, to ensure patient safety and combat health care fraud.  Stripping away the profit motive for circumventing physician supervision requirements has both a remedial and a deterrent effect.  The settlement announced today advances our critical interest in both the integrity of our health care system and the safe delivery of medical services.”

The allegations resolved by the settlement were brought in a lawsuit filed under the False Claims Act’s whistleblower provisions, which permit private parties to sue for false claims on behalf of the government and to share in any recovery.  The whistleblower in this case, Dr. Patrick Lynch, was a local radiologist and will receive $565,500.

This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius.  The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.  One of the most powerful tools in this effort is the False Claims Act.  Since January 2009, the Justice Department has recovered a total of more than $14.8 billion through False Claims Act cases, with more than $10.8 billion of that amount recovered in cases involving fraud against federal health care programs.

The investigation and settlement were the result of a coordinated effort among the U.S. Attorney’s Office for the Northern District of New York; the Justice Department’s Civil Division, Commercial Litigation Branch and the Department of Health and Human Services’ Office of Inspector General.

The case is United States of America ex rel. Lynch v. Imagimed LLC, et al. (N.D. N.Y.).  The claims released by the settlement are allegations only, and there has been no determination of liability.

SLEEP APNEA TESTER GETS $15.3 MILLION FINE FOR IMPROPER BILLING

FROM: U.S. DEPARTMENT OF JUSTICE
Thursday, January 3, 2013

Florida-Based American Sleep Medicine to Pay $15.3 Million for Improperly Billing Medicare and Other Federal Healthcare Programs

Facilities in Alabama, California, Delaware, Florida, Illinois, Indiana, Kansas, Kentucky, Maryland, Missouri, New Jersey, Tennessee, Texas and Virginia
Florida-based American Sleep Medicine LLC has agreed to pay $15,301,341 to resolve allegations that it billed Medicare, TRICARE – the health care program for Uniformed Service members, retirees and their families worldwide – and the Railroad Retirement Medicare Program for sleep diagnostic services that were not eligible for payment, the Justice Department announced today.

American Sleep, headquartered in Jacksonville, Fla., owns and operates 19 diagnostic sleep testing centers throughout the United States, including in Alabama, California, Delaware, Florida, Illinois, Indiana, Kansas, Kentucky, Maryland, Missouri, New Jersey, Tennessee, Texas and Virginia. The company’s primary business is to provide testing for patients suffering from sleep disorders such as obstructive sleep apnea. The test results are used by doctors to determine the most appropriate course of treatment for patients. The most common tool used to diagnose sleep disorders, particularly sleep apnea, is a procedure called polysomnographic diagnostic sleep testing. Under federal program requirements for the reimbursement of claims submitted for sleep disorder testing, initial sleep studies must be conducted by technicians who are licensed or certified by a state or national credentialing body as sleep test technicians.

The United States contend that Medicare and TRICARE claims submitted by American Sleep during this period were false because the diagnostic testing services were performed by technicians who lacked the required credentials or certifications, when it knew this violated the law. American Sleep submitted false claims to Medicare and TRICARE between Jan. 1, 2004, and Dec. 31, 2011, according to the United States’ allegations.

"Medicare patients and military families deserve to be treated by appropriately credentialed professionals when seeking medical care," said Stuart F. Delery, Principal Deputy Assistant Attorney General for the Justice Department’s Civil Division. "When companies providing those services seek to skirt the rules, there will be a steep price to pay."

"Pursuing health care fraud is a priority of my office and the Department of Justice. We will continue to work with the Department of Health and Human Services and the public to ensure that fraudulent claims are investigated and those responsible are required to pay," stated David J. Hale, U.S. Attorney for the Western District of Kentucky. "Medical providers who overbill Medicare defraud the taxpayers and drive up the cost of health care for us all. Recovering taxpayer dollars lost to fraud helps keep strong those critical public health care programs so many people depend on."

"Patients seeking care from licensed professionals deserve to receive exactly what was represented, and the taxpayer-funded Medicare program expects no less," said Derrick Jackson, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General Region IV, which includes Kentucky. "The company has agreed to Federal monitoring and reporting requirements designed to avoid such problems in the future."

The allegations covered by today’s settlement were raised in a lawsuit filed against American Sleep under the qui tam, or whistleblower, provisions of the False Claims Act. United States ex rel. Daniel Purnell v. American Sleep Medicine LLC, no. 3:07-cv-12-S (W.D. Ky.). The act allows private citizens with knowledge of fraud to bring civil actions on behalf of the United States and share in any recovery. Relator Daniel Purnell will receive $2,601,228 as part of today’s settlement.

In addition to the $15.3 million payment, American Sleep entered into a five-year Corporate Integrity Agreement with the Office of Inspector General of the Department of Health and Human Services. The agreement requires enhanced accountability and wide-ranging monitoring activities conducted by both internal and independent external reviewers.

Principal Deputy Assistant Attorney General Delery thanked the Office of the Inspector General for the Department of Health and Human Services, the Medicare Railroad Retirement Program, the Defense Criminal Investigative Service, the FBI, the U.S. Attorney’s Office for the Western District of Kentucky and the Commercial Litigation Branch for the collaboration that resulted in today’s settlement. The claims settled by this agreement are allegations only, and there has been no determination of liability.

This resolution is part of the government’s emphasis on combating health care fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by Attorney General Eric Holder and Kathleen Sebelius, Secretary of the Department of Health and Human Services in May 2009. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover $10.1 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 are over $13.9 billion.

U.S. DOD OFFERING NON-MEDICAL COUNSELING TO TROOPS AND THEIR FAMILIES

U.S. Navy photo Antonio P. Turretto Ramos. Blurred 01-02-2013 BRGNR.

FROM: U.S. DEPARTMENT OF DEFENSE

DOD Offers Non-medical Counseling to Troops, Families

By Army Sgt. 1st Class Tyrone C. Marshall Jr.
American Forces Press Service

WASHINGTON, Jan. 2, 2013 - The Defense Department continues to ensure the well-being of service members and their families through no-cost, short-term, non-medical counseling in the interests of military and family readiness, a defense official said.

Jena M. Moore, program analyst for counseling in the Office of Military Community and Family Policy, explained the program during an interview with The Pentagon Channel and American Forces Press Service.

"The Military and Family Life Counseling program ... offers short-term, non-medical counseling," Moore said. "And it's confidential for our service members and family members."

The program, administered by licensed professionals with master's or doctorate degrees in a mental health-related field, provide services for active duty, National Guard and reserve members and their families, as well as DOD civilians "serving as part of the expeditionary workforce and their families."

The program's goal, she said, is to prevent the development of or the exacerbation of mental health conditions that can detract from military readiness.

"Another goal of the program was to establish a different avenue of counseling for service members and family members, in addition to what's already available through their military community," Moore said.

Data indicates usage of non-medical counseling has increased from 10 percent of active-duty service members in 2003 to about 35 percent, she said.

According to Moore, the program provides non-medical counseling for issues that can be resolved or supported through short-term support.

"These are daily issues that come to our lives like dealing with work or dealing with family," she said. "And, specifically for the military community, it's those normal reactions that service members and family members can have to the stressful attributes that can come with being a military family member."

Moore said medical counseling is not provided through the program since such care typically would be used for health issues requiring longer-term care. Counselors ensure service members or family members are connected with the right resource before finishing the counseling sessions, she said.

"Examples of [medical counseling] would be issues related to child abuse, spouse abuse, or suicidal ideations," Moore said. "These are counseling sessions that you could find within a military medical treatment facility or through TRICARE."

Moore explained how the MFLC program delivers counseling to the military community in a variety of ways.

"One of the largest ways that we're utilized is on installations on rotations up to 180 days," she said. "And typically these MFLCs are found within our family support centers, but they also can be found throughout military installations as well as embedded in military units.

"We also have our child and youth behavioral MFLCs that support child and youth on installations," Moore continued. "Those can be found in our child development centers as well as public schools that have high populations of military children."

For commanders, Moore noted, there are surge support services available to units that are returning from combat. And there are on-demand medical services that primarily support National Guard and reserve members, she said, which are usually available at family events and during drill weekends and deployment-related events.

"If a commander is interested in receiving surge support for their unit that is returning from deployment, they would request through their family program manager at service headquarters," Moore said, "and then that request would come through to the MFLC program where we'd review it, and provide support as needed."

For troops with privacy concerns, the sessions with the MFLC counselors are confidential -- even their commander won't know -- and the counseling will not impact their security clearances, she said.

Additionally, Moore said, full-time program counselors can be accessed through joint family support assistance programs, available in all 50 states, territories and the District of Columbia.

And MFLC program options include speaking to a military chaplain, or going to a family support center, she said.

Moore said research data indicates the program is working.

"In a recent review of the MFLC program that was conducted by Virginia Tech, [of] those that were surveyed, 98 percent indicated that the MFLC counseling program was effective in dealing with their issues," she said.

Senior commanders like retired Navy Adm. Eric T. Olson, who led U.S. Special Operations Command, also have provided feedback, Moore said.

"In 2010, [Olson] spoke to the MFLC program and the support that the MFLC program provided his service members and family members," she said. "[Olson] mentioned how the MFLC program is flexible, and it's so accessible ... that his families and service members feel comfortable in utilizing it."

Olson "really thinks that it's a value added for his service members and family members to have that resource," Moore said.

WALGREEN PAYS $7.9 MILLION TO RESOLVE FALSE PRESCRIPTION BILLING ACCUSATIONS

FROM:  U.S. DEPARTMENT OF JUSTICE WEBSITE
Friday, April 20, 2012
Walgreens Pharmacy Chain Pays $7.9 Million to Resolve False Prescription Billing CaseAllegedly Offered Illegal Inducements to Government Health Care Programs Beneficiaries to Transfer Prescriptions to Walgreens
Walgreens, an Illinois-based corporation operating a national retail pharmacy chain, has paid the United States and participating states $7.9 million to resolve allegations that Walgreens violated the False Claims Act, the Justice Department announced today.

The settlement resolves allegations that Walgreens offered illegal inducements to beneficiaries of government health care programs, including Medicare, Medicaid, TRICARE and the Federal Employees Health Benefits Program (FEHBP), in the form of gift cards, gift checks and other similar promotions that are prohibited by law, to transfer their prescriptions to Walgreens pharmacies.  The government investigation alleged that Walgreens had offered government health beneficiaries $25 gift cards when they transferred a prescription from another pharmacy to Walgreens.  The company’s advertisements that promoted gift cards and gift checks for transferred prescriptions typically acknowledged that the offer was not valid with Medicaid, Medicare or any other government program.  Nevertheless, the government alleged that Walgreens employees frequently ignored the stated exemptions on the face of the coupons and handed gift cards to customers who were beneficiaries of government health programs, in violation of federal law.

“This case represents the government's strong commitment to pursuing improper practices in the retail pharmacy industry that have the effect of manipulating patient decisions,” said Stuart F. Delery, Acting Assistant Attorney General for the Civil Division of the Department of Justice.

The allegations were brought to the government by two whistleblowers, known as relators, in two separate whistleblower lawsuits filed under the qui tam, or whistleblower, provisions of the False Claims Act and state False Claims Act statutes.  The relators, Cassie Bass, a pharmacy technician formerly employed by Walgreens, and Jack Chin, an independent pharmacist, will receive $1,277,172 from the United States for their role in filing the qui tam actions.  The federal share of the settlement is $7,298,124.

“This case vindicates and protects the interests of consumers throughout the nation by ensuring that they remain free from undue influence by large retail chains when making decisions about which pharmacies to entrust their own individual health care,” said André Birotte Jr, U.S. Attorney for Central District of California.
   
“The law prohibits pharmacies from using their retail clout to lure patients whose prescriptions are subsidized by the government,” said Barbara L. McQuade, U.S. Attorney for the Eastern District of Michigan.  “Continuity with a pharmacist is important to detect problems with dosages and drug interactions.  Patients should make decisions based on legitimate health care needs, not on inducements like gift cards.”

“This settlement makes clear that corporations seeking increased profits over their patients' needs will pay a substantial price,” said Daniel R. Levinson, Inspector General for the Department of Health and Human Services.  “Violating Federal health care laws, as Walgreens allegedly did by offering incentives for new business, cannot be tolerated.”

This resolution is part of the government's emphasis on combating health care fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by Attorney General Eric Holder and Secretary of the Department of Health and Human Services Kathleen Sebelius in May 2009.  The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.  One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover more than $6.7 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department's total recoveries in False Claims Act cases since January 2009 are over $9 billion.

This case was investigated jointly by the Commercial Litigation Branch of the Justice Department’s Civil Division, the U.S. Attorney’s Offices for the Central District of California and the Eastern District of Michigan, the National Association of Medicaid Fraud Control Units and the Department of Health and Human Services, Office of Inspector General.
           
The claims settled by today’s agreement are allegations only; there has been no determination of liability.

PENTAGON COMMITTED TO QUALITY CARE OF MILITARY PERSONNEL

The following excerpt is from a American Forces Press e-mail:

Pentagon's Top Doctor Stresses Commitment to Quality Care

By Elaine Sanchez
WASHINGTON, March 29, 2012 - Even in this "belt-tightening era," Defense Department officials remain committed to sustaining efforts that have led to groundbreaking medical advances in areas such as post-traumatic stress disorder, the Pentagon's top health affairs official told an audience of behavioral health experts and military leaders here today.

"The leadership of the military health system -- to include the surgeons general of the Army, Navy and Air Force -- have been steadfast that the core mission of medical readiness responsibilities cannot and will not be compromised," said Dr. Jonathan Woodson, assistant secretary of defense for health affairs and director of the TRICARE Management Activity.

This includes the Pentagon's investment in medical research and development and in the nature of resilience, he added.

Woodson spoke at the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury's Warrior Resilience Conference, which is intended to provide service members, units, families and communities with resilience-building techniques and tools.

Defense Secretary Leon E. Panetta and Chairman of the Joint Chiefs of Staff Army Gen. Martin E. Dempsey have made it clear that the department will do its part in the reduction and growth of federal spending, Woodson said, and the health budget is not exempt.

Defense health programs encompass more than $53 billion of DOD's base budget of $525 billion, the doctor noted. "We really now are at 10 percent of the DOD's budget," he said. "We need to make sure those dollars spent are adding value to national defense and to the department."

Woodson warned against the impact of a possible "sequestration." Unless Congress agrees on an alternative by January, this provision of the Budget Control Act would trigger an additional $500 billion in across-the-board defense spending cuts over the next 10 years, which Woodson described as a "meat-ax" approach to cutting costs and programs. "We cannot let that happen, and we're not going to let that happen," he said.

Woodson said he's committed to protecting medical research and development programs, which have made great contributions to medical science. "It's easy in the short term, but painful in the long term to cut research and development budgets," he said. Instead, he explained, DOD needs to put in place a more "agile" structure that identifies best practices across the services and enables rapid information sharing.

This will save money that can be applied to programs such as research and development, he added.

But just having a program isn't enough, Woodson said. It must be effective and easily accessible. Nearly 400 programs designed to aid troops and their families are in place, he said, but there's a lack of metrics to gauge their effectiveness.

"My greatest fear with the meat-ax approach is they'll cut programs that are truly beneficial ... because we don't have a method of analysis that's robust," he said.

Woodson reiterated his commitment to ensuring troops and their families receive the best care possible. "I personally believe we are heading in the right direction on these organizational budgetary decisions," he said. "We will continue to provide exceptional service to all of those we serve."

The resources put forth to better understand how to prevent and treat psychological wounds are vital to service members and their families, who have been challenged as never before -- and vital to long-term national security interests, Woodson said. Nearly 11 years of war have "exacted a toll on service members and their families," he said.

Woodson stressed the importance of leadership and communication in building resilience. "The environment that a leader [creates] in his or her own unit, however small, has an enormously positive affect on resilience," he said.

This environment, he told the audience, should include the means for open communication. "That reaching out for help when feeling overwhelmed by life's stressors can help sustain or restore health," he said. "Seeking help is a sign of strength, and we need to ensure that those who serve know where to turn for help when it's required."

Woodson lauded the attendees for taking steps to understand the nature of resilience and to deepen their understanding of psychological issues. Their efforts will be increasingly important as the nation continues to face numerous and complicated" threats, he noted.

"No nation in history has ever put forward more resources, more research and more military leadership attention ... to help address and understand how to create and sustain a psychologically healthy force," Woodson said.

"The importance of your work and efforts ... is extraordinarily vital to people who serve," he added. "It's vital to extended families and the friends of men and women in uniform, and vital to long-term national security interests."
 

MILITARY HEALTH CARE REFORM

T

he following excerpt is from a Department of Defense American Forces Press Service e-mail:

Health System Seeks Savings While Retaining Excellence

By Jim Garamone
American Forces Press Service

WASHINGTON, March 9, 2012 - Iraq and Afghanistan have been dangerous places over the past decade, but deployed troops often passed a saying on to new arrivals: "If you've got to get shot, this is the best place to do it."

The saying spread because the medical care for wounded service members was state-of-the-art, with the survival rates significantly higher than in previous conflicts.

Dr. Jonathan Woodson, assistant secretary of defense for health affairs, told the House Appropriations Committee's defense subcommittee yesterday that he wants to retain this excellence while controlling spiraling costs.

"Over the last 10 years, the men and women of the Military Health System have performed with great skill and undeniable courage in combat," Woodson said. "Their contributions to advancing military and American medicine are immense. The Military Health System's ability to perform this mission and be able to respond to humanitarian crises around the globe is unique among all military and nonmilitary organizations on this globe."

All department leaders are committed to sustaining this precious resource, Woodson said. But he acknowledged that military health care is now more than $51 billion of the yearly defense budget. The 2011 Budget Control Act calls for $487 billion in defense cuts over the next 10 years, and the health care system is not immune, he said.

Military health System officials are taking four roads to savings, Woodson told the panel. The first is to find efficiencies inside the system. The second is a continuation of efforts to appropriately pay for private-sector providers. A third initiative promotes healthy lifestyle choices while seeking to reduce illnesses, injuries and hospitalizations. The last is proposed changes to beneficiary cost-sharing under the TRICARE military health plan.

The fiscal 2013 defense budget request includes this recommended path to reorganize the military health system, Woodson said. "We have learned a great deal from our joint medical operations over the last 10 years," he added, "and we recognize that there is much opportunity for introducing even a more agile headquarters operation that shares common services and institutes common clinical and business practices across our system of care."

Woodson noted that the recommended changes to TRICARE fees came about only after officials had explored other avenues of potential savings. "Before we even considered TRICARE fees, there were a number of initiatives and considerations taken," he told the committee.

DOD health affairs is looking to control headquarters costs, Woodson said, and it has had some success eliminating 780 full-time equivalent positions from the headquarters. Other efforts, he added yielded further savings.

"We put in a number of management reforms that have yielded very positive results in reducing costs, including a robust fraud and recuperative program that has yielded $2.6 billion over the last four years," he said.

In addition, Woodson said, a pharmacy management program has saved $ 3.4 billion, medical supply and acquisition standardization has saved $31 million, and an amalgamation of other efficiencies that saved about $1 billion.
 

REVIEW OF MILITARY HEALTHCARE FOCUSES ON SLOWING GROWTH OF COSTS

The following excerpt is from the Department of Defense American Forces Press Service:

"Chairman's Corner: The Military Health System

By Army Gen. Martin E. Dempsey
Chairman of the Joint Chiefs of Staff

WASHINGTON, Feb. 21, 2012 - I spent last week on Capitol Hill with our Secretary of Defense. The questions about our defense budget were tough — as they ought to be. The stakes are high.

There are no easy answers in cutting $487B from the budget, but we're not the first generation to face difficult budget challenges. We'll figure it out. The nation's counting on us.

Health care costs generated a lot of attention. I welcomed the opportunity to speak about this important part of the budget, to express my concerns about further cuts that could come due to sequestration, and to explain how we intend to keep faith with our armed forces — not just through pay and benefits but by ensuring we remain the best trained, best equipped, and best led military in the world.

In forming this budget, we looked at all cost variables. Many of you will know that pay and benefits account for more than 1/3 of the budget and that health care costs in particular have increased from $19B in 2001 to $48B today. We had to act to slow this growth.

I want those of you who serve and who have served to know that we've heard your concerns, in particular your concern about the tiered enrollment fee structure for TRICARE in retirement. You have our commitment that we will continue to review our health care system to make it as responsive, as affordable, and as equitable as possible."