Center for Vein Restoration to pay $4M in false claims settlement; injectable buprenorphine beats daily dose in pregnancy trial; algorithm beats self-monitoring for insulin titration – Morning Medical Update

Health care management firm to pay $4M over unnecessary procedure claims

Federal settlement resolves six years of alleged billing fraud targeting Medicare, Medicaid and TRICARE.

A Maryland-based vein treatment company and its physician CEO have agreed to pay $4 million to settle federal allegations that they billed Medicare, Medicaid and TRICARE for medically unnecessary procedures over a six-year period. CVR Management, LLC — which manages the Center for Vein Restoration and its 16 Maryland locations — along with the Center for Vascular Medicine and CEO Sanjiv Lakhanpal, M.D., allegedly submitted claims for sclerotherapy, radiofrequency ablation and endovenous laser ablation to treat chronic venous insufficiency when those procedures were not clinically indicated, according to the U.S. Attorney's Office for the District of Maryland. Federal coverage for such treatments requires that conservative alternatives first be tried and fail, and does not cover procedures performed for cosmetic reasons alone.

"Billing for medically unnecessary procedures saps public confidence in the health care system and is a drain on the public fisc," U.S. Attorney Kelly O. Hayes said. Two former CVR employees filed the whistleblower complaints that triggered the investigation and will share $752,000 of the settlement proceeds.

Weekly buprenorphine injection bests daily pill for pregnant patients

Weekly injectable buprenorphine outperformed daily sublingual treatment in a first-of-its-kind randomized trial.

Pregnant patients with opioid use disorder had significantly higher rates of illicit opioid abstinence when treated with weekly injectable extended-release buprenorphine than with the standard daily sublingual form, according to a randomized clinical trial published in JAMA Internal Medicine and supported by National Institutes of Health (NIH) funding. The study enrolled 140 pregnant adults and found that serious maternal adverse events were also less common in the extended-release group, while neonatal opioid withdrawal syndrome outcomes were similar between the two treatments.

Daily sublingual buprenorphine carries known drawbacks including misuse risk, adherence challenges and fluctuating blood levels that can leave cravings and withdrawal inadequately controlled. The injectable formulation is designed to address those issues.

An algorithm for type 2 diabetes

A UVA-developed algorithm paired with a continuous glucose monitor significantly outperformed standard self-monitoring in a small clinical trial.

A University of Virginia algorithm that analyzes continuous glucose monitor data to recommend weekly insulin dose adjustments helped type 2 diabetes patients spend far more time in a safe blood-sugar range than those who self-monitored, according to a study published in Diabetes Technology & Therapeutics. In the 16-week trial, 30 participants were randomized to use either the algorithm or standard self-monitoring; the algorithm group saw their average time in range climb from 54.1% to 75.3%, compared with a more modest increase from 50.2% to 55.3% in the self-monitoring group.