California accidentally signed up nearly half a million potentially ineligible people for Medicaid when the program expanded; Medicare's proposed opioid crackdown draws blowback from patients and providers; Aetna will also pass on drug rebates to consumers starting in 2019.
Nearly 500,000 people who may not have been eligible were accidentally signed up for Medicaid in California under the Affordable Care Act’s expansion of the program. A recent report found the state spent $1.15 billion on more than 366,000 ineligible and nearly 80,000 potentially ineligible expansion enrollees, reported Kaiser Health News. Only 10% of the questionable payments were covered by the state’s Medicaid program—the rest involved federal money.
A Medicare proposal to stop paying for long-term, high-dose prescriptions of painkillers has drawn criticism from patients with chronic pain, physicians, and experts in pain management and addiction medicine. According to The New York Times, there are concerns that the proposal would put patients into withdrawal or provoke them to buy drugs on the street. One-third of Medicare’s beneficiaries had been prescribed opioids in 2016.
Following UnitedHealth Group’s announcement, Aetna has also decided it will pass on drug rebates to consumers. The insurer will begin applying rebates at the time of sale for fully insured plan members starting in 2019, according to Aetna. However, only a limited slice of Aetna’s full customer base will see reduced prices from rebates. When insurers hold onto the rebates, they often use the money to lower their own costs or keep down premiums.