Following abuses, Medicare tightens reins on its drug program
US Medicare gives itself the power to ban physicians if they prescribe medications in abusive ways. The action follows a series of articles by ProPublica documenting inappropriate prescribing, waste and fraud in its popular drug program 
The federal government has granted itself potent new authority to expel physicians from Medicare if they are found to prescribe drugs in abusive ways, following through on a proposal issued earlier this year.
Under the rule finalized Monday, the Centers for Medicare and Medicaid Services also will compel health providers to enroll in Medicare to order medications for patients covered by its drug program, known as Part D. This requirement closes a loophole that had allowed some practitioners to operate with little or no oversight from Medicare.
CMS proposed the new rule following stories last year by ProPublica that documented how Medicare's failure to oversee Part D effectively had enabled doctors to prescribe inappropriate or risky medications, had led to the waste of billions of dollars on needlessly expensive drugs, and had exposed the program to rampant fraud.
Using five years of Part D data obtained under the Freedom of Information Act, ProPublica created a tool called Prescriber Checkup that, for the first time, allowed users to compare physicians' prescribing patterns to those of others in their specialties and states.
Part D now covers 37.5 million seniors and disabled patients. It pays for roughly one in every four prescriptions dispensed in the country, costing taxpayers $62 billion in 2012.
But despite the program's popularity, experts have complained that since Part D took effect in 2006, Medicare has placed a higher priority on getting prescriptions into patients' hands than on targeting problem prescribers. The U.S. Department of Health and Human Services' inspector general has repeatedly called for tighter controls.
The rule released Monday "will give CMS new and enhanced tools in combating fraud and abuse in the Medicare Part D program so that we can continue to protect beneficiaries and taxpayers," CMS administrator Marilyn Tavenner said in a statement.
In the past, Medicare said it had no authority to take action against doctors or other providers even if it found their prescribing behaviors troubling. The new rule changes that by giving officials the power to kick them out of the program if it finds their prescribing abusive, a threat to public safety or in violation of Medicare rules. CMS said it would use prescribing data, disciplinary actions, malpractice lawsuits and more to identify problem providers.
In addition, the agency will be able to strip away a physician's Medicare enrollment if his or her Drug Enforcement Administration registration certificate is suspended or revoked.
Medicare's proposed changes have drawn criticism from some who called the definition of "abusive" prescribing too vague or expressed concern that patients would lose access to needed drugs if their doctors were banned from the program.
But Medicare officials did not back down in a 487-page document released Monday describing and defending the new measures. They said they intended to expel providers only in "very limited and exceptional circumstances."
"Indeed, it will become clear to honest and legitimate prescribers...that our focus is restricted to cases of improper prescribing that are so egregious that the physician or practitioner's removal from the Medicare program is needed to protect Medicare beneficiaries," the agency wrote.
Medicare rebuffed suggestions that it should defer oversight of doctors entirely to state medical boards and the DEA. "States remain free to take action against physicians and practitioners as they deem fit," CMS wrote. "Again, though, Medicare is a distinct program that is under the purview of CMS, not the states."
CMS gave providers until June 1, 2015 to either enroll in Medicare or formally opt out. When they enroll, the government verifies their professional licenses and credentials and asks about their criminal histories. If they formally opt out, they could continue prescribing, but the government would have additional information about them. If they neither enroll nor formally opt out, Medicare will no longer cover drugs they order for beneficiaries.
Most health providers are already enrolled; among those affected will be dentists and Veterans Affairs physicians who currently provide services not covered by Medicare but have patients who fill prescriptions covered by the program. Though some commenters worried that these providers wouldn't be able to sign up before the new requirement takes effect, CMS said the June 2015 date provided plenty of time.
CMS previously had abandoned the most contentious element of the new rule—a provision that would have whittled down its list of "protected drug classes," vital drugs for which insurers cannot impose restrictions on use. The agency had wanted to remove antidepressants and immunosuppressant drugs from this list, giving insurers more latitude to require that patients receive prior approval before receiving certain brand-name medicines. Amid widespread opposition from the pharmaceutical industry and lawmakers, CMS agreed not to proceed on the issue this year.
Other provisions in the new rule would cut off Medicare drug coverage for incarcerated individuals and provide easier access to prescription drug data for researchers.
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As SEBI sleeps, Transgene Biotek hits upper and lower circuit on same day!
Transgene Biotek insiders are again playing the game of price manipulation, while market regulator SEBI had no time to either watch unusual price changes or deal with investor complaints
Transgene Biotek Ltd, the company that is been in the news over alleged misuse of global depository receipts (GDRs) and ignoring investor complaints, made a new record on Tuesday. During the first two hours of trading on the BSE, the Hyderabad-based company shares breached its both, lower and upper circuit. This not only shows extreme volatility but also a possible price manipulation.
Transgene Biotek opened Tuesday at Rs3.82, which was its lower circuit. It remained at this level till 9.25am. After that it started to move up. At 9.27am, Transgene was trading at Rs3.85 with a volume of 2,500 shares. Suddenly, at 9.37am, it jumped to Rs4.17 with a volume of 1,000 shares. The same price remained for next 11 minutes. Between 9.48am to 10am, Transgene saw volumes of 7,000 shares, but it also took its price down to Rs3.85 (Was somebody dumping the shares?). After 10am, there was again a surge in Transgene price. By 10.06am, the shares were trading at Rs4.14 with a volume of just 11 shares! By 10.40am, Transgene inched by three paise at Rs4.17 per share with a volume of 600 shares. Suddenly, at 10.42am, the volume surged to 5,000 with Transgene breaching its upper circuit. The next one minute again saw volumes of 4,403 shares at Rs4.22 per share.
As reported by Moneylife, several shareholders of the Hyderabad-based company are crying foul over the alleged misuse of global depository receipts (GDRs)—a financial instrument used to raise capital overseas, and several “well-timed” announcements by the company. However, market regulator Securities and Exchange Board of India (SEBI) is to yet even acknowledge several complaints filed by these shareholders.
The shareholding pattern of Transgene between June 2012 and September 2012 quarters reveal ‘precise’ share transactions between ‘related parties’. During these two quarters, custodian shareholding decreased to 39% from 73.44%, a difference of 34.44%. However, during the same period, public shareholding, including foreign institutional investors (FIIs), domestic institutional investors (DIIs) and non-institutions, increased significantly to 51.22% from 16.78% in June 2012, again a difference of 34.44%. So while custodian stakeholders were selling Transgene shares, the ‘public’ was buying exactly the same quantity.
Move forward to December 2013, and one can see the exit of FII and substantial stake sell by custodians. At the same time, public shareholding or stake hold by non-institutional investors increased to 70.04% at the end of December 2013 quarter, as per the data from BSE. Even, promoters seem to have increased their stake to 21.68% during the December 2013 quarter from less than 10% in September 2012.
As of March 2014, promoter and promoter group held 21.68% stake in Transgene Biotek. Public shareholders, including minority shareholders hold 70.04% stake, while institutions and custodians own 5.03% and 8.28% shares in Transgene Biotek.
 Another interesting part is promoter or promoter group held 9.8% stake during September 2012 and yet citing lower share price tried to delist Transgene Biotek from stock exchanges. On 4 September 2012, Transgene board announced its decision to delist its shares. Three days later, it announced delisting price of over Rs25 per share as against the prevailing price of only Rs10.36 per share. 
Shareholders allege that the company had deliberately announced its delisting at a price 2.5 times more than its prevailing share prices for manipulation. The company apparently sent postal ballots for getting approval from shareholders for delisting. However, there was no response from shareholders, the company said. The question here is after all, why will shareholders disapprove such a “generous” proposal? According to shareholders, either they received the postal ballots just one day prior to the deadline or never received any such thing.
One such shareholder in his complaint to SEBI has asked many questions on Transgene’s GDR issue as well as its price manipulative intentions behind delisting announcement. The shareholder in his complaint said, “We (shareholders) believe that the promoters did not have any intention of de-listing the company in which they only hold 9.8% shares. If they were serious about their holding in the company, they would have increased their stake through creeping acquisition. If their co-investors were serious about taking a strategic stake in the company, they would have bought out the GDRs outstanding or made an open offer to buy out from public without the ‘delisting’ clause. The structured GDR is normally used as an end game by promoters, who hardly have any holding in the listed entity and are looking forward to milk whatever remains of their company and their reputation in the market place. The modus operandi is similar and operations are through a small clutch of entities which your intelligence wing can find out just by going through the bulk deals done in the small/ mid cap companies with low promoter holding which have also issued a GDR despite their poor financial performance.”
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arun adalja

2 years ago

company made market fool by delisting announcement at rs 25 when market price was 9 rs and sebi allowded such things.companies are doing manipulation and watchdog sebi sleeps like kumbhkarana.


2 years ago



2 years ago

Company Background

Industry Name: Textiles - Readymade Apparels

House Name: Haria Group

Incorporation Date: 01/02/2011 Face Value: 10.0

ISIN: INE493N01012

Market Lot: 1

Company History - Haria Apparels Limited

Haria Apparels Limited was incorporated on February 01, 2011 under the Companies Act, 1956, with the Registrar of Companies, Mumbai. The Registration no. and CIN assigned to our Company is 212887 and U18204MH2011PLC212887 respectively. The Registered Office of the Company is situated at 8, Subhash Road, Ville Parle (East), Mumbai, Maharashtra – 400 057, India

Major Events
Incorporation as Haria Apparels Limited

Received Certificate for Commencement of Business

Increase in Authorised Capital from Rs 5,00,000 divided into 50,000 equity shares of Rs 10/- each to Rs 8,00,00,000 divided into 80,00,000 equity shares of Rs 10/- each

Allotment of 79,50,000 equity shares of Rs 10/- each

Board Resolution for approval of composite scheme of arrangement

The Hon’ble High Court of Mumbai, Maharashtra, has approved the Scheme of Arrangement/ De-merger of HEL whereby the Garment Division of HEL has been transferred to and vested in Haria Apparels Limited

Shareholder Resolution for approval of composite scheme of arrangement

Vidul Nagda

2 years ago

There are scores of such scrips.

One is Haria Apparels (BSE 538081. It has traded between a high of 297 (Mid-April) to 55.30 today. Cant sell shares as there is a lower circuit everyday.

Dont know why it was delisted and then reliste in April 2014.


2 years ago

Take note of price manipulation in the following ‘SIX’ stocks:-
Risa International Limited
Mathew Easow Research Securities Limited
Westlife Development Limited
Channel Nine Entertainment Limited
Polson Limited
Matra Kaushal Enterprise Limited

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