Congress has gone out of town for a two week long State/district work period. Congress returns to Capitol Hill on October 15. 

In other news,

• The Health and Human Services Department’s Inspector General reports that in September the federal government brought charges against “35 individuals for their alleged participation in healthcare fraud schemes involving $2.1 billion in losses. In the alleged scheme, recruiters (aka marketers) get a Medicare beneficiary to take a genetic test. The recruiter then gets a doctor to sign off on the genetic test so a lab will process the test. The recruiter pays the doctor a kickback in exchange for ordering the test. Then the lab processes the test and bills Medicare. Medicare reimburses the lab for the test and the lab shares the proceeds of that payment with the recruiter.”  That’s a big bowl of wrong. 

• Kaiser Health News reports on insurer efforts to reduce maternity costs. 

In traditional coverage, insurance payments for some women are delivered as bundled payments for portions of their prenatal care, said Suzanne Delbanco, executive director of Catalyst for Payment Reform, an organization that helps advise employers and other organizations that buy health coverage. However, the latest version is different because insurers are adding quality measures that increase accountability and additional services, such as delivery costs, to the bundle.

• The National Institutes of Health reports that the agency “has awarded $945 million in total fiscal year 2019 funding for grants, contracts and cooperative agreements across 41 states through the Helping to End Addiction Long-term Initiative or NIH HEAL Initiative. The trans-NIH research effort aims to improve treatments for chronic pain, curb the rates of opioid use disorder (OUD) and overdose and achieve long-term recovery from opioid addiction.” 

• Health Payer Intelligence digs into the Kaiser Family Foundation study on employer health costs. The sub headline says it all — Plans do not want to narrow provider networks because employers prefer large networks, but it may be the only means of substantially lowering healthcare spending.”