Policy & Law

Inspector General Highlights Latest Episode in Medicare Waste

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It’s not only the direct providers of patient care — the physicians, NPs, PAs, and other ancillaries — with whom one has to worry about issues of drug diversion and other modalities of inappropriate prescribing of narcotics; it’s also CMS. The feds yesterday announced the findings of a report based upon data from 2009 that alleges Medicare’s involvement in the inappropriate renewal of Schedule II narcotics as part of the Part D prescription benefit.

 

It’s not only the direct providers of patient care — the physicians, NPs, PAs, and other ancillaries — with whom one has to worry about issues of drug diversion and other modalities of inappropriate prescribing of narcotics; it’s also CMS. The feds yesterday announced the findings of a report based upon data from 2009 that alleges Medicare’s involvement in the inappropriate renewal of Schedule II narcotics as part of the Part D prescription benefit.

The report said nearly 400,000 Schedule II prescriptions were wrongly refilled, or about 2 percent of all Schedule II prescriptions billed  under Medicare Part D in 2009. Of those 400,000, more than 25,000 also lacked some required information, including the name, address or signature of the prescriber.

Medicare fraud is one thing, but the lack of streamlined bureaucratic process that results in over $25M in the inappropriate dispensing of potentially abused drugs underscores that reform of Medicare and Medicaid is a heck of a lot more than a one-trick pony. It’s more than making some weak-willed promise to “create oversight” to ”curb” the problem. It’s more than just touting photo ops in which unscrupulous prescribers are showcased to “prove” the war on fraud is actually proceeding nicely. It’s about restoring trust in a program’s original reasons for existence, and it will take much, much more than a ideological presidential campaign promise to make the system work and benefit those who need it most. |

 

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