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Thursday, Dec 19 2024

Full Issue

Justice Dept. Claims CVS' Push To Fill Prescriptions Fueled Opioid Crisis

On Wednesday, the DOJ accused CVS of using compensation incentives to push pharmacists to fill as many prescriptions as possible without assessing their legitimacy first. Meanwhile, big retailers providing health care look at ways to pivot in 2025; VA investigation into mental health providers; and more.

The Justice Department on Wednesday accused CVS Pharmacy of incentivizing pharmacists to fill illegal opioid prescriptions for more than a decade, a practice that fueled the nation鈥檚 opioid crisis. The complaint, filed in Providence, Rhode Island, where CVS is headquartered, alleges that the country鈥檚 largest retail pharmacy violated the False Claims Act and Controlled Substances Act by filling prescriptions for controlled substances that lacked legitimate medical purpose or were not valid, including prescriptions for 鈥渄angerous and excessive quantities of opioids.鈥 (Ziegler, 12/18)

Big retailers providing healthcare services have a lot to prove in 2025. This past year was a defining year for retailers and not necessarily in a good way, as there were multiple failed attempts at offering more healthcare services.聽For Walmart and Walgreens, the high costs of care and reimbursement pressures derailed their plans to disrupt healthcare and grow revenue. ... Meanwhile, CVS Health, Kroger and Amazon are forging ahead with plans to offer more services through brick-and-mortar clinics and virtual platforms. (Hudson, 12/18)

About 850 employees will be laid off when Steward Health Care closes Sharon Regional Medical Center in Pennsylvania early next year. Layoffs will be effective Jan. 6 and include 149 professional staff members and 699 line staff members, according to Worker Adjustment and Retraining Notification documents filed this week. (Hudson, 12/18)

A program designed to educate veterans on the various treatments for mental health conditions actually hindered access to medical care and contributed to the underuse of six therapists at a Georgia Veterans Affairs clinic, a Department of Veterans Affairs investigation found. The VA's Office of Inspector General found evidence that the Hinesville VA Outpatient Clinic did not adequately manage its Choose My Therapy program, which informs patients of the different types of available care. The clinic also did not use its scheduling tools properly, leading to delays in care. (Kime, 12/18)

Insurance developments 鈥

A mandatory hospital payment model finalized this year by the Centers for Medicare and Medicaid Services could make earnings uncertain for providers, researchers said. Under the聽Transforming Episode Accountability Model, or TEAM, hospitals could lose out on an average of $500 per episode of care covered in the model, according to a December report from the聽Institute for Accountable Care. But the forecast results vary widely: Hospitals in the Minneapolis-St. Paul region could gain an average of $900 per episode of included care, the report said, while Denver providers stand to lose $1,300 per episode, on average.聽(Early, 12/18)

Jessica Linart was shocked at the Medicare Advantage premiums insurers proposed for covering retired Colorado civil servants next year. Linart, director of insurance for the Colorado Public Employee Retirement Association, had grown accustomed to health insurance companies making competitive bids for group Medicare Advantage contracts. In the past, insurers pitched multiyear deals that locked in affordable rates. Not this time, she said. (Tepper, 12/18)

Tempus announced this morning it has inked agreements for in-network provider status with Blue Cross Blue Shield health plans in six states, significantly enhancing its relationships with commercial health plans. Chicago-based Tempus uses artificial intelligence for diagnostic testing, health data analysis and supporting therapeutic development, primarily in cancer care. (Asplund, 12/18)

In pharmaceutical news 鈥

A synthetic opioid more powerful than fentanyl is at the center of a Los Angeles County case that is the first-of-its-kind in the nation. The prosecution, involving a 22-year-old victim, is the first to focus on a death caused by the drug, authorities said. Protonitazene is three times more potent than fentanyl, according to The Center for Forensic Science Research and Education. (Van Der Brug, 12/18)

A drug approved by the FDA over the summer is giving new hope to the nearly 7 million Americans suffering from Alzheimer's disease. The drug, sold under the brand name Kisunla and produced by drugmaker Eli Lilly, slows down the disease by up to 35%, according to the company. Kathy Ingebrand of Mahtomedi is one of the first people in the country to receive the infusion. On Thursday, Ingebrand was receiving her fourth round of monthly treatments. (Rantala, 12/18)

Billionaire author and philanthropist MacKenzie Scott acknowledged another $2 billion in donations in a blog post on Wednesday, bringing the total she鈥檚 given away since 2019 to $19.2 billion. She also revealed new information about how she was managing her wealth, saying she had directed advisors to invest her funds into 鈥渕ission-aligned ventures.鈥 Most of the grants she made in 2024, she said, went to bolstering economic security and opportunities. (Beaty, 12/18)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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