The Daily Scan

August 23, 2018

Last Updated: 8:55 AM EST

Litigation

  • The Justice Department filed a complaint to bar two Ohio doctors from prescribing medications after an investigation revealed they recklessly and unnecessarily distributed painkillers and other drugs. Temporary restraining orders—a first-of-its-kind against doctors allegedly prescribing opioids illegally under the Controlled Substances Act (CSA)—were served this week that forbid Michael P. Tricaso, D.O., of Akron, and Gregory J. Gerber, M.D., of Sandusky, from writing prescriptions. Making the announcement, Attorney General Jeff Sessions said, “Today’s announcements are a warning to every trafficker, every crooked doctor or pharmacist, and every drug company, every chairman and foreign national and company that puts greed before the lives and health of the American people: this Justice Department will use civil and criminal penalties alike and we will find you, put you in jail, or make you pay.” (Justice.gov: Press Release, Transcript of Sessions' Remarks)

Medicaid

  • Yesterday, the Centers for Medicare and Medicaid Services (CMS) released a letter to State Medicaid Directors that clearly describes CMS’s current approach to calculating budget neutrality expenditure limits for Medicaid section 1115 demonstration projects. Medicaid demonstration projects allow states to design innovative ways to better serve the nation’s more than 65 million Medicaid recipients. In response to longstanding concerns raised by the Government Accountability Office (GAO), this letter marks the first time that CMS has formally outlined how states must calculate budget neutrality for demonstration projects, in order to strengthen fiscal accountability. (CMS.gov: Press Release; Medicaid.gov: Letter)

 

  • Illinois Governor Bruce Rauner this week signed a bill package that increases access to mental health and substance use disorder treatment and addresses the state's opioid crisis. "We are taking steps to dramatically improve mental health and substance use disorder treatment for the people of Illinois," Rauner said. "These five initiatives work together to improve the quality of care and hopefully, the quality of life for so many Illinoisans suffering from mental health and substance use disorders."

    • Senate Bill 1707 improves insurance companies' coverage of mental health and substance use disorder treatments and strengthens the ability of the Department of Insurance to protect consumers. 

    • Senate Bill 682 allows providers to give immediate access to outpatient treatment by removing prior authorization barriers. 

    • Senate Bill 3049 expands access to behavioral and mental health experts for Medicaid patients by allowing them to utilize telehealth technology.

    • Senate Bill 3023 partners law enforcement agencies with licensed substance abuse service providers.

    • Senate Bill 2951 provides the Department of Healthcare and Family Services the opportunity to apply for a waiver that would allow treatment for serious mental illness on the first episode of psychosis. (Illinois.gov)

 

  • The state of Ohio recently released 2018 Ohio Medicaid Group VIII Assessment, a follow‐up report to the 2016 Ohio Medicaid Group VIII Assessment. The report found that, in general, Medicaid expansion has been beneficial to Ohio Group VIII enrollees by: 1) facilitating continued employment, new employment, and job‐seeking; 2) increasing primary care and reducing emergency department use; 3) lessening medical debt and financial hardship; 4) improving mental health; 5) assisting in addressing unhealthy behaviors such as tobacco use; and 6) enabling enrollees to act as caregivers for family members. Compared to the 2016 Group VIII Assessment, a higher percentage of all Group VIII enrollees are now employed, access primary care providers, use emergency department services less, report better mental health, and are optimistic about their individual functioning. (Medicaid.Ohio.gov)

 

  • Seventeen of the nation’s leading health systems, comprising 280 hospitals, are joining forces to identify, develop, and scale financially sustainable solutions that improve the health of underserved individuals and families in their communities. The Medicaid Transformation Project is a national effort to transform healthcare and related social needs for the nearly 75 million Americans who rely on Medicaid. The work will focus on five critical challenges facing vulnerable populations across the country, including behavioral health, women and infant care, substance use disorder, and avoidable emergency department visits. Solutions that meet the needs of this diverse population will improve care for all vulnerable populations. The Medicaid Transformation Project will be led by AVIA, creators of the nation’s leading network for health systems seeking to innovate, and Andy Slavitt, former Acting Administrator of CMS and Founder and General Partner at Town Hall Ventures. (AVIAHealthInnovaton.com)

 

 

 

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