Morning Briefing
Summaries of health policy coverage from major news organizations
Texas GOP Criticizes Medicaid Change; Dems Say It Will Help Uninsured
Houston Chronicle: Biden 'Has All The Cards' As He Pushes Texas To Expand Medicaid. But It May Take Time.
Texas Republicans have been swift to condemn the Biden administration for rescinding early approval of a multibillion dollar Medicaid program that would help fund emergency care for the state’s booming uninsured population through 2030. Gov. Greg Abbott said the federal government was “deliberately betraying Texans.” Attorney General Ken Paxton vowed to “use every legal tool available to regain the assistance Texans need.” (Blackman, 4/20)
Austin American-Statesman: Abbott Blasts Biden Administration Decision To Block Health Care Safety Net For Uninsured Texans
Gov. Greg Abbott on Friday said the Biden administration is “obstructing healthcare access for vulnerable Texans” after officials rescinded approval for a waiver that delivers billions in federal dollars to hospitals in Texas. In a letter to the state, federal Medicaid officials said the Trump administration’s decision to fast-track approval of the $100 billion waiver in January was made in error, without enough time for public comment. (Mekelburg, 4/17)
In other Medicaid news from Illinois, Mississippi and Arkansas —
News-Gazette: House Bill Would Free Up Medicaid Spending For Autism Treatment
In Illinois, private insurance has covered applied behavior analysis, or ABA, therapy for only about 10 years. Low-income families covered by Medicaid aren’t eligible for the service to be covered, even though ABA therapy is the only evidence-based therapy proven to help children with autism. ... Help might be on the way from Springfield. Legislation filed in the Illinois House would free up millions of dollars in Medicaid coverage for autism treatment after a previous bungled attempt in 2019. (Valley, 4/19)
Mississippi Center for Investigative Reporting: Mississippi Investigating Medicaid Drug Services Provider Centene
The state auditor and Mississippi attorney general are investigating whether Centene Corp., as a provider of Medicaid drug services, failed to disclose discounts on pharmacy services, inflated dispensing fees and received reimbursements for amounts already paid. Ohio Attorney General Dave Yost made similar allegations in a lawsuit. “Corporate greed has led Centene and its wholly owned subsidiaries to fleece taxpayers out of millions,” he said. “Centene has broken trust with the state of Ohio, and I intend to hold this company accountable for its deceptive practices.” (Mitchell, 4/18)
Arkansas Democrat-Gazette: Medicaid-Funding Bill Falls Short On 4th Try
For the fourth time in the past week, a bill to grant spending authority for Arkansas' Division of Medical Services in the next fiscal year fell short of obtaining the required three-fourths vote for approval in the Arkansas House of Representatives. According to legislative leaders, the difficulty in passage last week was connected to conflicting proposals to reduce the tax on the sale of used cars. Furthermore, if the Medical Services appropriation fails to pass, then lawmakers will have to rework a different bill that sets spending priorities for general revenue. That bill must pass if the Legislature is to recess by April 30. (Moritz, Wickline and Herzog, 4/20)
In Medicare news —
KHN: Humana Health Plan Overcharged Medicare By Nearly $200 Million, Federal Audit Finds
A Humana Inc. health plan for seniors in Florida improperly collected nearly $200 million in 2015 by overstating how sick some patients were, according to a new federal audit, which seeks to claw back the money. The Health and Human Services Office of Inspector General’s recommendation to repay, if finalized, would be “by far the largest” audit penalty ever imposed on a Medicare Advantage company, said Christopher Bresette, an HHS assistant regional inspector general. (Schulte, 4/20)
Modern Healthcare: 10% Of Prescription Drugs Make Up Majority Of Medicare Drug Spending, Study Finds
New data suggest that a targeted approach to negotiating the most expensive Medicare drugs could significantly impact federal drug spending. A Kaiser Family Foundation study has found that the top selling 7% and 8.5% of drugs covered by Medicare, part D and B respectively, take up the majority of the federal government's Medicare spending. The 250 top selling drugs, each with one manufacturer and no competitive products on the market, account for 60% of net total Medicare part D spending. The top 50 selling drugs, also with one manufacturer each and no competitors, account for 80% of total Medicare part B spending. (Gellman, 4/19)
Fierce Healthcare: AHA Counters Site-Neutral Medicare Payments With Study Highlighting Hospitals' More Complex Outpatients
The American Hospital Association (AHA) is reinforcing its longstanding position against the Department of Health and Human Services’ (HHS') site-neutral payments with new research suggesting hospital outpatient departments are treating poorer, more complex Medicare patients than independent physicians' offices are. The study, which was conducted for the AHA by KNG Health Consulting and published on its website, reviewed claims from a 5% sample of Medicare beneficiaries who had at least one visit to an outpatient setting between Jan. 1, 2012, and June 3, 2019. (Muoio, 4/19)
