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»  Posts By   February 2016 

Health Care Marketplace Mergers on the Rise Creating Mega Carriers: Aetna Acquiring Humana for $37 Billion

On October 19, 2015, Aetna Inc. and Humana Inc. announced that their respective shareholders had approved Aetna's proposed acquisition of Humana, which was originally announced on July 3, 2015. Pursuant to the proposed acquisition, Aetna will purchase all outstanding shares of Humana for a combination of cash and stock valued at $37 billion. Aetna is currently the third largest health insurer by revenue, and Humana is the fourth, and the...

FDA Warns New Jersey Hospital About Institutional Review Board

Monmouth Medical Center (MMC), a New Jersey hospital, received a warning letter from the U.S. Food and Drug Administration (FDA), after an inspection of its Institutional Review Board (IRB) found it failed to follow regulations meant to protect clinical trial participants, including for pediatric studies. In the warning letter, the FDA says the hospital's IRB failed to document whether it reviewed certain studies involving children to ensure the studies provided...

Carriers Seek to Spin Regulatory Violations into Violations of the New Jersey Insurance Fraud Prevention Act

The Insurance Fraud Prevention Act (IFPA) was designed to prevent people from defrauding insurers by submitting insurance claims containing materially false information. In the healthcare context, a clear cut example of such prohibited conduct would be a physician who submits a health insurance claim form to a carrier for medical services he or she knows were never rendered. The IFPA allows private parties, including insurance carriers, to sue healthcare providers...
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