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This week's takedown shows that the fraud prevention and enforcement efforts that began nearly a decade ago are bearing fruit, including the change to predictive modeling to spot suspicious billing in Medicare.

Exposure of patients to the dangers of certain diagnostic equipment can have unwanted long-term effects, which healthcare providers may be underestimating, according to research conducted at the University of Saskatchewan.

What we're reading, June 24, 2016: Britain's decision to leave the European Union will impact drug regulation; Supreme Court decision derails California proposal to allow illegal immigrants to buy health insurance; and lawmakers look to reduce exclusivity period for biologics.

HHS and the Department of Justice announced a nationwide sweep led by the Medicare Fraud Strike Force resulting in charges against 301 individuals for their alleged participation in healthcare fraud schemes involving $900 million in false billings.

An appellate panel found that a group of hospitals could not have information that Horizon withheld during discovery in 2 breach of contract suits related to its OMNIA tiered health plan. An attorney for 1 group of those hospitals said it will appeal because consumers and providers need to know how the tiered health network was created.

A report developed by Avalere Health, based on a survey that the company conducted among health plans in 2015, states that a majority of health plans want to sign outcomes-based contracts with biopharmaceutical companies, especially for oncology and hepatitis C drugs.

A new study in the New England Journal of Medicine has established that, at least in the case of lymphoma, a positron emission tomography (PET) scan can spare the patients serious side effects of chemotherapy.

The study comes as regulators put increased emphasis on long-term cardiovascular outcomes trials to ensure safety of diabetes and obesity therapies. The American Journal of Managed Care recently convened an expert panel on the topic.

What we're reading, June 23, 2016: Medicare's fund will be insolvent 2 years earlier than estimated last year; nearly 1 in 3 Medicare beneficiaries received an opioid prescription in 2015; House Republicans' health plan calls for greater use of value-based insurance design; and the Democrats urge the Department of Justice to block Anthem-Cigna and Aetna-Humana mergers.

While the United States healthcare system has been slowly transitioning to value-based care from a system based on volume, a recent study found that primary care physicians and health plan executives aren’t actually on the same page.

A new analysis by the Dartmouth Institute has found that Medicare accountable care organizations (ACOs) are making modest yet increasing gains when treating patients with comorbidities.

Despite known mental health disparities on the basis of sexual orientation and nonbinary gender identification, researchers are not reporting sexual orientation and transgender identities of study subjects in psychotherapy outcome studies for anxiety and depression.

The Department of Justice has found that the Nevada Department of Corrections has been discriminating against inmates with HIV and with disabilities, according to a letter of findings issued.

House Speaker Paul Ryan said the policy outline represents the first consensus among his conference to replace "Obamacare," which the document says has not worked because it has limited choice, increased consumer costs, and created new regulatory burdens for employers.

Addressing the unmet social needs of patients requires additional investment on the part of the healthcare industry, but provides a tangible return on investment.

A scoping document explaining the review process to evaluate existing treatment options for non-small cell lung cancer (NSCLC) has been released by the Institute for Clinical and Economic Review (ICER).

June 1 kicked off the 22nd annual Men’s Health Month. While raising awareness among male patients is a focus of Men’s Health Month, primary care providers can also play a role

What we're reading, June 22, 2016: Obama administration targets young individuals for Affordable Care Act enrollment; Boeing is directly contracting with a major California health system to provide employee benefits; growing interest in the use of value-based insurance design.

The Supreme Court ruled to uphold a new process for challenging patents that the pharmaceutical industry was hoping would be struck down. Generic drug companies and health insurance plans supported the new rule, which could help lower prices.

What we're reading, June 21, 2016: potential Zika virus vaccine to be tested in humans; California regulator approved the potential merger between Aetna and Humana; and 5 states will be the testing ground for a new Medicare initiative to reduce fraud.

A study assessed the reliability of a 12-gene Recurrence Score test to reveal the natural course of recurrence among Japanese patients with stage II and III colon cancer who have undergone surgery but not received any adjuvant chemotherapy.

Study’s findings add to concerns about health plans’ incentives not to comply with their legal obligation under the law to provide mental health benefits on par with medical and surgical benefits.

Groups seeking grants under the new program must show how they can train small practices without charging the doctors or their practices.

If the announcement by the Swiss pharmaceutical giant Novartis holds true, biosimilars that the company plans to launch over the next 4 years could create a significant dent in the sales of 5 blockbuster molecules in the oncology and immunology space.

The Affordable Care Act has helped many Americans gain access to health coverage, and a recent analysis from HHS discovered that rural America in particular has benefited.

The Affordable Care Act and additional legislation that has mandated extending mental health parity coverage are contributing to an increased demand for mental health services that the United States is not meeting.

What we're reading, June 20, 2016: employers are cutting back on wellness benefits; new apps and websites provide birth control prescriptions to women; and Novartis pledges to triple the number of biosimilar drugs on the market by 2020.

Researchers at the John Hopkins Bloomberg School of Public Health found that increases in unemployment in California during the Great Recession were associated with an increased risk for weight gain among 1.7 million public school children in the state.