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What We're Reading: Appealing the 340B Ruling; Medicaid Payment Errors; Reducing Veterans' Suicides
Three hospital groups are appealing a ruling that dismissed a lawsuit challenging the new cuts to the 340B program; report finds poor oversight of data repository resulted in $36.7 billion in payment errors in 2017; a new executive order will expand mental health care for new veterans.
Hospital Groups to Appeal 340B Ruling
The American Hospital Association, the Association of American Medical Colleges, and America's Essential Hospitals will appeal a ruling that dismissed a lawsuit over 340B cuts. According to The Hill, the initial lawsuit was dismissed on December 29, because it was filed before the rule took effect. The rule will result in $1.6 billion in cuts to hospitals participating in 340B, and the hospital groups are arguing that the change violates federal law.
Poor Oversight Led to Medicaid Payment Errors
A report from the Government Accountability Office found that a lack of oversight of Medicaid data resulted in $36.7 billion in payment errors in 2017, alone. Healthcare Finance reported that those payment errors are up from an estimated $14.4 billion in fiscal year 2013. Last year, 49 states began reporting data to the national repository, but data challenges, such as incomplete data, have hindered oversight.
Executive Order Expands Mental Health Care for Veterans
A new executive order is attempting to reduce suicides among transitioning veterans as they leave the military. The order provides new veterans with mental health care for at least 1 year after they leave the military, reported The Washington Post. President Donald Trump has given 60 days for the Departments of Defense, Homeland Security, and Veterans Affairs to develop a joint plan, and they are expected to report back to the president within 180 days on the implementation of the new plan.
Urticaria Diagnosis Challenged by Overlapping Pruritic Skin Conditions
April 23rd 2025Urticaria is complicated to diagnose by its symptomatic overlap with other skin conditions and the frequent misclassification in literature of distinct pathologies like vasculitic urticaria and bullous pemphigus.
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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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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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