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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.
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
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Insurance Gaps Threaten Cancer Treatment Success
July 7th 2025Access to and affordability of immune checkpoint inhibitors, which can be lifesaving if patients receive them on time and under optimal circumstances, continue to top the list of reasons behind outcomes disparities for patients who have private insurance vs those who remain uninsured.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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From Red Tape to Relief: Rewriting the Rules of Prior Authorization
June 23rd 2025Up to 257 million Americans could benefit from these prior authorization reforms that could have cross-market implications on health care plans administered through commercial insurers, Medicare Advantage, and Medicaid.
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