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HHS Auditors Find Possible Excess Medicare Payments for Hospice Beneficiaries' Drugs
The Medicare program could be paying multiple times for prescription drugs for hospice beneficiaries, a new federal report suggests.
Read the full story: http://tinyurl.com/6v4bews
Source: ModernHealthcare.com
HHS' inspector general's office conducted a nationwide review of prescription drugs for hospice beneficiaries between January and December 2009 and found that Medicare Part D paid for a variety of prescription medications—including analgesic, anti-nausea, laxative and anti-anxiety drugs and drugs to treat chronic obstructive pulmonary disease—that should have been covered under the per diem payments made to hospice organizations under Medicare Part A. Investigators found 198,543 hospice beneficiaries who, through the Medicare Part D program, received 677,022 prescription drugs that potentially should have been covered under the daily payments made to hospice organizations. Meanwhile, Part D paid pharmacies more than $33.6 million for these drugs, and beneficiaries paid more than $3.8 million in copayments.
What's at Stake as Oral Arguments Are Presented in the Braidwood Case? Q&A With Richard Hughes IV
April 21st 2025Richard Hughes IV, JD, MPH, spoke about the upcoming oral arguments to be presented to the Supreme Court regarding the Braidwood case, which would determine how preventive services are guaranteed insurance coverage.
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Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Comparing Breast Cancer Treatment Outcomes Between Fee-for-Service and Medicare Advantage
April 4th 2025This study examined postdiagnosis breast cancer treatment outcomes for Medicare Advantage vs fee-for-service (FFS) Medicare in Ohio and found no significant differences overall but disparities for Black patients with FFS Medicare.
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