As Prescription Drug Costs Spiral, States Struggle To Find Ways To Keep Medicaid Spending Down
Although state Medicaid programs have price controls through rebates paid by the drugmakers, spending on prescription drugs has been growing rapidly, spurred in large part by expensive specialty drugs, such as those used to treat hepatitis C. In addition, reports on Medicaid news from Massachusetts and Iowa.
The Hill:
States Struggle With Rising Medicaid Drug Costs
As prescription drug prices continue to rise, states are struggling to find ways to cover the costs to Medicaid, which could mean unwelcome changes for beneficiaries and health plans. States have implemented policies to prevent spending exorbitant amounts of money on drugs, but as prices continue to rise, experts said some hard decisions will have to be made. States can use tactics like preferred drug lists, prior authorization, and even comparative effectiveness reviews, but those may not be enough if recent pricing trends continue. States could dramatically scale back benefits by doubling down on policies that limit medications or cut reimbursements to health plans. (Weixel, 10/10)
Boston Globe:
State Cuts Off Second Home Health Provider; 800 Patients Affected
A second home health provider is transferring hundreds of patients after a fraud investigation led the state to cut off Medicaid payments to the company. The disruption affects about 800 patients who were served by Avenue Homecare Services Inc. of Lawrence. It started transferring patients in late September, following a decision by officials at the state’s Medicaid program, called MassHealth, to stop paying the company in August. (Dayal McCluskey, 10/10)
Des Moines Register:
Are Branstad’s Medicaid Claims ‘Smoke And Mirrors?’
Iowa is unable to provide data to back up Gov. Terry Branstad's claims that says a controversial move to privatize Medicaid has resulted in thousands of additional contracts with medical providers, a Des Moines Register investigation has found. The governor's office asserted in a July 25 press release that the state has at least 9,300 more contracts with doctors; 3,200 more contracts with nurse practitioners and nearly 1,300 more contracts with physical therapists than it did before private companies began managing its Medicaid program in April. (Clayworth, 10/10)