Medicare Overpaid $251 Million in 18 Months for Drugs
By reimbursing certain drug providers based on outdated pricing, Medicare has squandered millions of dollars that could have been saved if the recommendations of a government watchdog had been followed.
As reported by The Washington Examiner, the Office of the Inspector General for the Health and Human Services Dept. found that Medicare has continued to pay providers of infusion drugs, which are delivered through IV pumps, at higher prices than necessary. HHS is paying providers based on 2003 prices when the drugs were more expensive--this despite warnings from the IG, most recently in February, 2013.
“Medicare payment amounts for infusion drugs…substantially exceeded the estimated acquisition costs,” according to findings reported on the IG’s website.
The IG said that had its recommendations been implemented, $251 million would have been saved over an 18-month period.
The Centers for Medicare & Medicaid Services (CMS) apparently ignored the IG when it proposed that the agency push legislation that would have brought the method of reimbursement for infusion drugs in line with the process for other pharmaceuticals. As an alternative, the IG recommended that the CMS employ competitive bidding to supply infusion drugs.
“CMS partially concurred with the first recommendation, but has not taken steps toward seeking legislation,” The IG’s report said. “CMS concurred with the second recommendation but said subsequently that…infusion drugs will not be included in competitive bidding until at least 2017.”
So presumably the overpaying won’t stop anytime soon.
Quote of the Day: A Big Hurdle for the Tax Cuts
“He goes in and campaigns on an issue, and the challenge is he then talks about executing drug dealers. Why do you think the press is going to cover the tax cuts if you’ve given them the much more exciting issue?”
-- Grover Norquist, president of tax-cutting advocacy group Americans for Tax Reform, on President Trump’s failure to sell the tax law.
The Obamacare Mandate That Could Produce $12 Billion in Fines in 2018
Republicans effectively eliminated the individual Obamacare mandate in the tax package signed late last year. Although the new regulation reducing the mandate penalty to zero doesn’t take effect until 2019, President Trump has cited the rule change as a victory over the health law so many conservatives oppose. “Essentially, we are getting rid of Obamacare. Some people would say, essentially, we have gotten rid of it," Trump told a crowd in Michigan two weeks ago.
However, many parts of the Affordable Care Act are still in effect and will continue to operate even after the individual mandate is eliminated in 2019.
In particular, the employer mandate, which requires companies with more than 50 employees to offer health benefits or face fine of roughly $2,000 per worker, will continue to play a significant role in the Obamacare system. The Congressional Budget Office estimates that the mandate will produce more than $12 billion in fines in 2018 alone.
Some conservative groups are pushing lawmakers to stop enforcing the employer mandate, but the IRS is still working to enforce the law. According to The New York Times Monday, the IRS is sending out notices to more than 30,000 businesses that have failed to comply.
Chart of the Day: It’s Still the Economy, Stupid
Security may be the top policy issue for Republican voters, but the economy is the top concern for Democrats, independents and voters overall, according to Morning Consult’s latest polling on the midterm elections. Health care is third on the list, followed by “seniors’ issues.” The results are based on surveys with more than 275,000 registered U.S. voters from February 1 to April 30.
Number of the Day: $13 Billion
An analysis by Bloomberg finds that the roughly 180 companies in the S&P 500 that have reported earnings for the first three months of the year saved almost $13 billion thanks to the corporate tax cut enacted late last year. Those companies’ effective tax rate dropped by more than 6 percentage points on average. About a third of the tax savings went to 44 financial firms.
How a Florida Doctor with Social Ties to Trump Delayed a $16B Billion VA Project
A West Palm Beach doctor who is friends with Ike Perlmutter, the chairman of Marvel Entertainment and an informal adviser to President Trump on veterans’ issues, has held up “the biggest health information technology project in history — the transformation of the VA’s digital records system,” Politico’s Arthur Allen reports. Dr. Bruce Moskowitz “objected to the $16 billion Department of Veterans Affairs project because he doesn’t like the Cerner Corp. software he uses at two Florida hospitals, according to four former and current senior VA officials. Cerner technology is a cornerstone of the VA project. … Moskowitz’s concerns effectively delayed the agreement for months, the sources said.” Read the full story.