A federal judge last week temporarily prohibited Arkansas from blocking Medicaid payments to Planned Parenthood, expanding her order requiring the state to continue paying for services for three patients who had sued over the move. Republican Gov. Asa Hutchinson last year terminated the organization’s Medicaid contract because of secretly recorded videos made by an anti-abortion group. Planned Parenthood praised the ruling. Attorney General Leslie Rutledge, a Republican, said she was disappointed with the decision.
Some state officials want to opt out of a CMS rule effective this week that requires them to assess how easy it is for fee-for-service Medicaid beneficiaries to receive primary care and pre- and post-natal obstetric services and see specialists and behavioral health experts, among other services. Scofflaws could see their federal funds withheld if they don’t comply. States with at least 90% of beneficiaries in managed care, like Florida, say there’s no point in spending the time to conduct the assessment of its Medicaid population. In the final access rule, the CMS estimated it could take states as long as 15,000 hours to develop the plans. Tennessee was successful in getting a pass on the rule because its fee-for-service enrollees generally had other forms of coverage such as Medicare, according to Medicaid spokeswoman Sarah Tanksley.
Horizon Pharma will pay $65 million to settle a lawsuit over $166.2 million in rebate payments that Express Scripts said it was owed from Horizon. The settlement comes after Horizon countersued Express Scripts, contesting the amount owed and alleging a breach of contract by the pharmacy benefit manager. The suit relates to rebates for Duexis, Rayos and Vimovo, which are some of Horizon’s most popular drugs and are used to treat rheumatoid arthritis and osteoporosis, among other diseases. Neither party will admit any fault or wrongdoing in the settlement. The drugmaker expects to record the payment as a reduction in sales revenue in the third quarter of this year.