Watchdog Says Medicare Part D Drug Plans Had Role In Opioid Crisis

Stat: Report Finds Medicare Part D Plans Improperly Authorized Opioids
A government watchdog found that Medicare drug plans improperly authorized thousands of prescriptions for certain powerful opioids over a recent four-year period, a failure that cost taxpayers $86 million as the opioid crisis was raging across the U.S. (Silverman, 3/2)

In other news about Medicare and Social Security —

The New York Times: Brokers Get Lush Trips and Cash Perks to Sell Costly Medigap Plans
Federal and state regulators are being urged to increase their oversight of insurance agents and brokers selling Medigap policies, the private supplemental coverage owned by millions of people with traditional Medicare that pays out-of-pocket costs. These brokers received paid vacations and cash bonuses to enroll customers in plans offered by specific companies, according to a report released Wednesday by Senator Elizabeth Warren, the Massachusetts Democrat. (Abelson, 3/1)

Axios: Medicare Advantage Yielded Strongest Margins For Insurers, Study Finds
Health insurers' margins in Medicare Advantage were more than double those seen in other markets in 2021, reinforcing the way the program can produce strong financial returns for plans, a new Kaiser Family Foundation analysis shows. (Dreher and Reed, 3/1)

The Hill: Senate Group Wades Into Tough Talks On Social Security 
A bipartisan group of senators is treading carefully into the politically difficult discussion of making changes to Social Security to extend its solvency.  Senators from both parties who have been involved in the talks are tight-lipped when it comes to revealing details, though reports have begun to surface of discussions of potential changes to the age threshold for retirement and raising the taxable wage cap. (Folley, 3/1)

In Medicaid developments —

St. Louis Post-Dispatch: Missouri Should Refund $34 Million In Medicaid Payments, Federal Agency Says
A federal agency is pushing Missouri to refund more than $34 million in Medicaid payments, after an audit raised issue with some of the state’s policies for programs that help patients with day-to-day tasks. In the audit, the Health and Human Services Office of Inspector General looked at claims filed for personal care assistance, which offers help with daily tasks like meal preparation, shopping, grooming and bathing. The audit found that in some cases, time sheets couldn’t be provided or lacked detail. In other cases, documentation was missing for the attendants who provided the care. (Merrilees, 3/1)

KHN: After People On Medicaid Die, Some States Aggressively Seek Repayment From Their Estates 
Fran Ruhl’s family received a startling letter from the Iowa Department of Human Services four weeks after she died in January 2022. “Dear FAMILY OF FRANCES RUHL,” the letter began. “We have been informed of the death of the above person, and we wish to express our sincere condolences.” The letter got right to the point: Iowa’s Medicaid program had spent $226,611.35 for Ruhl’s health care, and the government was entitled to recoup that money from her estate, including nearly any assets she owned or had a share in. If a spouse or disabled child survived Ruhl, the collection could be delayed until after their death, but the money would still be owed. (Leys, 3/2)

KHN: California’s Massive Medicaid Program Works For Some, But Fails Many Others
Newborns. Former inmates. College students. Expectant moms. People with disabilities. Foster kids. Homeless people. Single dads. Your neighbor. Your co-worker. You. California’s Medicaid program, called Medi-Cal, serves a whopping 15.4 million people, offering care from cradle to grave: Half of all births are covered by Medi-Cal, as are more than half of all stays in nursing homes. Everything about Medi-Cal is massive, from its upcoming fiscal year budget of $139 billion to the expansive list of benefits and services it offers. The way the program works — or doesn’t — could spell life or death for many enrollees. (Hart and Wolfson, 3/2)