National Roundup: VA Didn’t Follow Proper Procedures By Denying Sexual Trauma Claims
A top Veterans Affairs official says the agency will review all the denied medical claims dating back to late 2016. In other news, the Trump administration is offering confusing messages about drug price middlemen, a look at a religious conservative and his ties to the administration, federal officials ask a court to order Anthem to testify in a billing practices investigation and the GAO is concerned about lax auditing of Medicaid managed care plans.
USA Today:
VA Wrongly Denied Hundreds Of Veteran Claims Of Military Sexual Trauma
The Department of Veterans Affairs improperly denied hundreds of military sexual trauma claims in recent years, leaving potentially thousands of veterans suffering from post-traumatic stress disorder without benefits, a VA inspector general investigation found. Last year alone, the investigation found the agency mishandled as many as 1,300 sexual trauma claims. Some 12,000 veterans file for sexual trauma-related PTSD benefits each year. (Slack, 8/21)
Stat:
The Trump Administration Can't Decide Whether To Boost PBMs Or Rein Them In
Some days, President Trump vows to eliminate them. But then, there are days when his top health lieutenants promise to empower them. There are even days when they do both. The mixed and muddled signals from the administration are over the increasingly contentious role of the pharmacy benefit managers, or PBMs. Those discordant signals reflect a lack of clarity from Trump and his lieutenants over how best to address one of their top priorities: how to lower prescription drug prices. (Swetlitz, 8/22)
California Healthline:
Religious Conservatives’ Ties To Trump Officials Pay Off In AIDS Policies, Funding
Shepherd Smith, a strong supporter of abstinence-only sex education for AIDS, has been close to the new director of the CDC for decades. This connection is just one example of the “new in crowd” surrounding the Trump administration, where politics and religion mix. (Taylor, 8/22)
Modern Healthcare:
Feds Want To Force Anthem To Comply With Medicare Billing Investigation
Health insurer Anthem has refused to comply with the U.S. Justice Department's investigation into its Medicare Advantage billing practices, according to federal court documents filed Tuesday. So the Justice Department this week asked the U.S. District Court for the Southern District of New York to force Anthem to comply with a civil investigative demand issued in March to provide testimony .... The Justice Department asked for Anthem's testimony as part of an investigation into whether Anthem unlawfully obtained hundreds of millions of dollars in Medicare Advantage risk-adjustment payments in violation of the False Claims Act by submitting inaccurate patient diagnosis codes to the CMS. (Livingston, 8/21)
Modern Healthcare:
GAO Urges Scrutiny Of Medicaid Managed-Care Organizations
The U.S. comptroller general on Tuesday urged a Senate panel to tighten oversight of Medicaid providers and managed-care plans, and criticized the Obama administration's lax auditing of Medicaid insurers as millions joined the rolls through expansion. Comptroller General Gene Dodaro and CMS Administrator Seema Verma urged lawmakers on the Senate Homeland Security and Governmental Affairs Committee to look at managed care in expansion states, particularly when they cover large swaths of the Medicaid population. Improper Medicaid payments soared to an estimated $37 billion in fiscal 2017, and Dodaro argued that the federal government needs to join forces with state auditors to combat the issue. (Luthi, 8/21)