Tennessee practice to pay $2.8M over nonphysician billing; flu season gets a head start; cannabis tied to higher stroke odds — Morning Medical Update

Tennessee practice to pay $2.8M over nonphysician billing

The government alleged the group billed nonphysician practitioners' services under physicians' provider numbers.

Premier Medical Group, a multi-physician practice in Clarksville, Tennessee, will pay $2.8 million to resolve allegations that it violated the False Claims Act by improperly billing Medicare and TRICARE, the U.S. Attorney's Office for the Middle District of Tennessee announced, Clarksville Now reported Nov. 3.

The settlement covers claims submitted from Nov. 1, 2018, through May 31, 2023, for services performed by nonphysician practitioners that the government alleged were billed under physicians' National Provider Identifier numbers. "Federal health care programs depend on providers following the rules and billing taxpayers accurately," said U.S. Attorney Braden H. Boucek.

Premier did not admit wrongdoing and is not required to enter a corporate integrity agreement. In a statement, the practice said the matter "is related solely to a coding issue" that it discovered, self-reported and resolved several years ago, and that it did not involve quality of care or billing any patient or payer for a service that was not provided.

Flu season gets a head start

The CDC already counts at least 900 deaths and the season's first pediatric death.

Influenza activity is still low nationally but has been climbing since late August and early September and is higher than typical for this time of year, according to the Centers for Disease Control and Prevention (CDC) FluView report for the week ending Oct. 24.

The CDC estimates at least 1 million illnesses, 16,000 hospitalizations and 900 deaths from flu so far this season. Hospitals reported 6,100 laboratory-confirmed flu admissions that week, 7.6% of specimens tested at clinical laboratories were positive and the first influenza-associated pediatric death of the 2026-27 season was reported. Influenza A(H1N1)pdm09 made up 98.9% of the subtyped influenza A viruses reported by public health laboratories.

The agency cautioned that an early rise does not necessarily mean a higher peak or a more severe season. Its forecasts point to a likely national increase in flu hospital admissions and emergency department visits through the week ending Nov. 14, and the CDC continues to recommend annual flu vaccination.

Cannabis tied to higher stroke odds

The heaviest users didn't carry the biggest risk.

Adults who reported using cannabis had higher odds of a past cardiovascular disease diagnosis, particularly stroke, in an analysis of 442,906 U.S. adults to be presented at the American Heart Association (AHA) Scientific Sessions 2026, Nov. 6-9 in Chicago. Researchers used Behavioral Risk Factor Surveillance System telephone survey data from 2020 through 2024.

Compared with no use, using cannabis one to five days a month was tied to 23% higher odds of reported cardiovascular disease and 40% higher odds of stroke, while using it 16 to 30 days a month was tied to 21% and 25% higher odds, respectively. How often people used cannabis showed no statistically significant link to heart attack. "We were surprised to find that the link between cannabis use and cardiovascular disease was not straightforward," said study author Aabha Divya, M.B.B.S., M.Ch., an assistant professor in the division of cardiothoracic surgery at Tulane University School of Medicine.

The results are preliminary, capture a single point in time and rely on self-reported use and diagnoses, so they cannot show that cannabis causes stroke. Robert L. Page II, Pharm.D., M.S.P.H., who chaired the AHA's 2020 scientific statement on cannabis and was not involved in the study, said "clinicians should be addressing cannabis use with their patients as they would tobacco use."