What We're Reading: Mich. Medicaid Work Rules Blocked; DOJ Investigates Nursing Homes; Costco Buys Stake in PBM

March 5, 2020
AJMC Staff
AJMC Staff

A federal judge has invalidated Medicaid work requirements in Michigan; the Department of Justice (DOJ) launches an initiative to root out the worst nursing homes; wholesale retailer Costco purchases a stake in a pharmacy benefit manager (PBM).

Federal Judge Strikes Down Michigan’s Medicaid Work Requirements

Medicaid work requirements that went into effect in Michigan this January have been struck down by a federal judge, leaving Utah as the only state with such requirements in effect. According to the AP, the Healthy Michigan program was preparing to inform more than 80,000 Medicaid recipients that they were at risk of losing coverage after not complying with the requirements in January. Democratic Governor Gretchen Witmer praised the order from US District Judge James Boasberg, who had issued the ruling that was affirmed last month to reject Medicaid work requirements in Arkansas.

Department of Justice Announces National Nursing Home Initiative

The Department of Justice (DOJ) announced in a press release the launch of an initiative that will coordinate civil and criminal efforts to identify and penalize nursing homes that provide “grossly substandard care.” The effort has already resulted in investigations into 30 nursing facilities in 9 states. Actions—or neglectful instances of inaction—that will be pursued by the initiative include use of physical or chemical restraints, lack of hygiene protocols, inadequate food, or failure to prevent bed sores.

Costco Purchases Stake in PBM Owned by SSM Health

Big-box retailer Costco has purchased a minority stake in the pharmacy benefit manager (PBM) Navitus Health Solutions, owned by nonprofit hospital system SSM Health. Modern Healthcare noted that the deal could steer Navitus members toward Costco’s in-store pharmacies and increase the reach of its own PBM, which could integrate with the new acquisition. Both SSM Health and Costco operate transparent PBMs, which return rebates and discounts from manufacturers to clients.