Walmart settles opioid dispensing claims for $50 million; CMS says it blocked $1.6 billion in suspect lab payments; teens using AI for emotional support report more distress — Morning Medical Update

Walmart settles opioid dispensing claims for $50 million

The settlement resolves allegations that Walmart pharmacies filled invalid prescriptions written by known pill mills.

Walmart agreed to a $50 million settlement resolving allegations that its pharmacies illegally filled thousands of invalid prescriptions for opioids and other controlled substances, the Justice Department and Drug Enforcement Administration (DEA) announced Aug. 28. The complaint, filed in Delaware federal court in 2020 and amended in 2022, alleged that since June 2013 members of Walmart’s compliance team knew certain prescribers were operating as pill mills but filled their prescriptions anyway, despite thousands of refusal-to-fill forms submitted by the company’s own pharmacists.

Prosecutors also alleged that pharmacists filled prescriptions carrying obvious red flags, including dangerous opioid combinations, repeated high-dose fills and requests for early refills. Walmart entered a memorandum of agreement with the DEA requiring it to set up a hotline for employees and patients to report suspected illegal dispensing, monitor dispensing patterns across its pharmacies and establish a process for evaluating suspect prescribers. The claims are allegations only, and there has been no determination of liability.

CMS says it blocked $1.6 billion in suspect lab payments

The agency credits machine-learning models that flag unusual Medicare billing patterns before claims are paid.

The Centers for Medicare & Medicaid Services said Aug. 28 that enforcement actions have stopped more than $1.6 billion in potentially improper Medicare laboratory payments, a total the agency measured from the start of the Trump administration. The figure includes $732 million tied to the revocation of 157 lab providers, more than $500 million halted through 185 payment suspensions across an investigation of 600 labs, $276 million recouped from 442 identified overpayments and $127 million prevented through 85 law enforcement referrals.

CMS attributed the results to advanced analytics, including artificial intelligence (AI) and machine-learning models that mine fee-for-service claims for unusual billing patterns and can hold, reject or deny claims before payment. The agency said it targeted labs billing for services never rendered, up-coded claims and medically unnecessary tests ordered for beneficiaries with no established relationship to the ordering provider. Other figures in the announcement cover fiscal year 2025 or 2026 to date.

Teens using AI for emotional support report more distress

One in five students in a large Canadian survey reported turning to chatbots for emotional support.

Students who used generative AI chatbots for emotional support reported more emotional problems than students who did not, according to a cross-sectional study published Aug. 31 in JAMA Pediatrics. Researchers analyzed survey responses from 39,761 students in grades 4 through 12 across four school boards in Ontario, Canada. A total of 8,408 participants, or 21.1%, reported having used AI for help with their feelings or for advice on dealing with other people.

Those students scored higher on an emotional problems scale than nonusers (mean, 1.04 vs. 0.67), and 57.7% met a clinical threshold for emotional problems, compared with 29.2% of nonusers. The association held after adjusting for loneliness, perceived mattering, school-related AI use and demographic characteristics. Using AI for schoolwork showed a much weaker association. The cross-sectional design cannot establish whether distress precedes AI use or follows it, and the authors recommend clinicians screen for the behavior as a marker of underlying need.