• District of Columbia: FTC is sending almost $100 million in refunds to consumers who bought fake health plans marketed by Benefytt Technologies. According to FTC's complaint in August 2022, Benefytt operated under several different names, including Health Insurance Innovations, and used aggressive marketing and fraudulent websites to persuade consumers to buy fake policies with high monthly fees. These policies offered little coverage, and consumers were often billed for additional items they did not agree to buy, even if they requested to cancel the policy. "Benefytt pocketed millions selling sham insurance to seniors and other consumers looking for health coverage," said Samuel Levine, director of FTC's Bureau of Consumer Protection. As part of the settlement, Benefytt has agreed to pay around $100 million for consumer refunds. Over 450,000 customers who paid the company $1,000 or more between 2017 and 2022 will be eligible for a refund. In addition to the refund, the settlement permanently bans Benefytt's former CEO Gavin Southwell and VP Amy Brady from selling or marketing any healthcare-related products. Brady has also been banned from telemarketing. (Lee, CBS News, 3/22)
• New York: According to a new study from Peterson Health Technology Institute (PHTI), most digital diabetes management tools are not cost effective and do not provide patients with clinically relevant outcomes. For the study, researchers evaluated diabetes management products from several companies, including DarioHealth, Glooko, Teladoc Health, and Virta. They also conducted a literature review and observed patients' reported blood glucose levels. Overall, the researchers found that many of the products resulted in small, but not clinically meaningful reductions in a common blood sugar measurement. Many of these products also led to a net increase in spending that was greater than the savings patients received from avoided care. "After a lot of years on the market and a lot of investment, the digital diabetes management solutions haven't lived up to their promise," said Caroline Pearson, PHTI's executive director. For their part, some of the companies included in the study pushed back against the findings, citing their own data and peer-reviewed research that better supported the efficacy of their products. (Turner, Modern Healthcare, 3/21)
• North Carolina: US Radiology Specialists recently named Lee Cooper its next CEO, succeeding the company's founder and current CEO John Perkins on April 1. Cooper was previously president and CEO of GE Healthcare Systems and, most recently, was CEO of Shields Health Solutions before it was acquired by Walgreens in 2022. "My top priority is ensuring US Radiology is the destination of choice — both for people who want to work in the healthcare industry and patients who need our services," Cooper said. In addition to Cooper's new role as CEO, the company also appointed Molly Joseph, former CEO of United Healthcare Global* and current board member, to succeed Perkins as board chair. (DeSilva, Modern Healthcare, 3/21)

(*Advisory Board is a subsidiary of UnitedHealth Group, the parent company of UnitedHealthcare. All Advisory Board research, expert perspectives, and recommendations remain independent.)

Download our cheat sheet to learn about fraud and abuse regulations, how to guard against potential violations, and prepare to have conversations with health system executives about compliance programs.