The National Council of Prescription Drug Plans offers a white paper that defines a process that sponsors can use to communicate information about overutilization of opioids when beneficiaries switch health insurance plans.
ProPublica uncovers that prescribers of particular drugs might have monetary motives in doing so. They reported that speakers fees and other perks coincided with the prescribing patterns of top prescribers. New ACA mandates for full disclosure of these prescriber-manufacturer relationships hope to determine how widespread this practice has become.
This study gathered drug utilization statistics from a county in Minnesota with a demographic distribution similar to that of the entire U.S. It found that nearly 70% of the population received a prescription drug from at least 1 drug group and over half received prescriptions from 2 or more groups.
- The most commonly prescribed drug groups in the entire population were antibiotics, antidepressants, and opioid analgesics.
- Vaccines/toxoids, antibiotics, and antiasthmatic drugs were most commonly prescribed in persons younger than 19 years.
- Antidepressants and opioid analgesics were most commonly prescribed in young and middle-aged adults.
- Cardiovascular drugs were most commonly prescribed in older adults.
- Women received more prescriptions than men for several drug groups, in particular for antidepressants.
- For several drug groups, use increased with advancing age.
This week, top OIG officials within HHS testified at a Senate Committee hearing discussing prescription drug abuse in Medicare. The two officials, Gary Cantrell and Stuart Wright, offered a comprehensive review of the Part D program’s current flaws and challenges.
This analysis used 2009 PDE data to investigate prescription drug abuse in the Part D program. It found that Medicare inappropriately paid for drugs ordered by practitioners without proper prescribing rights. The list of non-prescribers included massage therapists, interpreters, chiropractors, and counselors and the types of prescribed drugs included controlled substances.
A key element of the ACA is the 80/20 MLR restriction for health insurance plans. According to the Department of Health and Human Services, this requirement saved 77.8 million consumers $3.4 billion in premium expenses. CMS insists that insurance companies operated more efficiently in 2012.
This bi-annual report addresses Medicare payment differences across ambulatory settings, offers recommendations for refining Medicare’s new hospital readmissions reduction program, analyzes hospice payment policy issues, and discusses the care needs for dual-eligible beneficiaries.