What We're Reading: Duplicate Medicare Payments; Long-Term Antidepressant Use Worries; Nebraska Medicaid Expansion

AJMC Staff

Part D Paid Millions for Drugs Already Covered by Hospice Benefits

A new government analysis revealed that despite a previous warning, CMS failed to take steps to ensure that Medicare Part D does not also pay for drugs that should be covered under the Part A hospice benefit. This resulted in $161 million in duplicate payments in 2016. According to STAT News, duplicate payments were pointed out in 2009 by a 2012 report issued by HHS’ Office of the Inspector General (OIG). In the new analysis, the OIG found that Part D paid $422.7 million for 6.7 million prescriptions for beneficiaries who received hospice care. Hospice organizations should have paid for the drugs and hospices or beneficiaries should have paid for the remaining $262 million in Part D total cost.

Health Officials Raise Concerns Over Long-Term Antidepressant Use

With studies of antidepressants’ safety and efficacy only following patients for a few years and with more people taking antidepressants for longer periods of time, health professionals are concerned that some people taking the drugs for extended periods shouldn’t be and are thus subjecting themselves to side effects and potential health risks. According to The Wall Street Journal, some studies have suggested some serious potential risks, including one meta-analysis that found people who used antidepressants had a 14% higher risk of heart attacks and strokes and a 33% increased risk of death.

Advocates in Nebraska Push for Quicker Expansion Rollout

Medicaid advocates in Nebraska have filed a lawsuit to try and force the state to implement Medicaid expansion no later than November 17, 2019, reported The Hill. According to the lawsuit, the state will miss out on approximately $149 million in federal funding by delaying implementation until October 1, 2020. The suit also says that beginning expansion in November this year will allow federal funds to pay for 93% of the cost of expansion. Voters in the state approved a ballot measure last November that would expand coverage to approximately 94,000 residents in the state. State officials have said they need time to implement expansion methodically and that 2020 implementation would allow them to do so.
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