Daily Rounds: Government Probes CVS; Hospital Union Vote; Dual-Eligible Experiment; End School Football?

CVS Caremark has become a frequent subject of government probes (The Los Angeles Times) - "Retired social worker Nina Nestor got an all-too-familiar phone call last week: Her prescription refill was ready at her CVS store in San Clemente. Trouble is, the 83-year-old cancer patient didn't ask for the refill or numerous others that CVS pharmacists filled this year without her permission. "The pharmacist told me after two weeks they put it back in stock and reverse the billing," Nestor said. "But I wonder about that." Government officials share her concerns. Allegations that the pharmacy giant has been automatically refilling medications without patient consent — and possibly overbilling insurers and government programs for unused medicine — have sparked four government investigations in recent weeks, the most recent by the U.S. Justice Department."

Massachusetts leading the way on dual eligibles (Governing) "The folks in Massachusetts, which is already a health-care reform pioneer in so many ways, however, think they’ve figured out the answer — at least partially. And they’re focusing their efforts on a group that's routinely responsible for a disproportionate share of Medicare and Medicaid spending: dual eligibles. Dual eligibles (people who qualify for both government programs) account for only 15 percent of Medicaid enrollment, but 39 percent of its costs. At least 26 states have pledged to develop pilot programs to better coordinate care between Medicaid and Medicare, but Massachusetts was the first to gain approval from the Centers for Medicare and Medicaid Services (CMS) for its duals demonstration project, which will be partially modeled after two existing programs in the state that are aimed at moving away from a fee-for-service model. If they can work for dual eligibles, the thinking goes, they should be able to work for everyone. Perhaps as importantly, the coordinated care approach that both programs use should allow them to remain solvent even as the population ages."

Morton hospital workers back union (The Boston Globe) - "The overwhelming majority of nearly 500 employees at Morton Hospital in Taunton have voted to join Local 1199 of the Service Employees International Union, in what union officials described as the largest union organizing vote of the year in Massachusetts. Workers taking part in the vote at the 152-bed Taunton hospital included respiratory therapists, radiology technicians, licensed practical nurses, nurse assistants, housekeepers, environmental services workers, and dietary workers, according to the union. Morton is owned by Boston-based Steward Health Care System."

A town's passion for football, a retired doctor's concern (The New York Times) - DOVER, N.H. — The agenda for the Oct. 1 school board meeting did not call for anything particularly exciting. But during a segment called “Matters of Interest,” Paul Butler, a retired doctor and relative newcomer to the board, floated an idea: end the football program at Dover High School. Speaking in his soothing, deliberative tone, Butler said, 'I’m beginning to believe, from what I’ve read of the literature, that as governors of the school district, we have a moral imperative to at least begin the process of ending this game in Dover.'"