Many steps have been put into place to help Medicare’s prescription drug program. These initiatives that were put into place to help stop fraud and abuse have made significant changes despite a new report from the inspector general of Health and Human Services. This report’s release is after the arrests of 44 pharmacy owners, doctors and others who are accused of ripping off the program known as "Part D".
The two reports from the inspector general of Health and Human Services were recently released. They provided more details and information about the fraud that had taken place and it also provided ways to help prevent this going forward.
The first report covered a lot of data that is filled with incredible information. Questionable billing practices were suspected by over 1400 pharmacies! These questionable billing practices included extremely high numbers of prescriptions per patient and others being billed for very high numbers of narcotics. All together they billed Medicare Part D for $2.4 billion.
Medicare Part D provides drug coverage for over 39 million senior citizens and disabled people at a coast of $121 billion in 2014. The inspector general has been investigating wrong doing and has been very open about the fact that Medicare has been a failure at keeping an eye on doctors, pharmacies and beneficiaries and of even the people paid to evaluate fraud cases.
The second report from the inspector general says that Medicare needs to create new reforms in the way it handles cases of fraud. Currently, the agency that handles potential fraud encourages plans to voluntarily report suspicions of fraud but it does not mandate them.
A major change that is being looked into is restricting patients suspected of doctor shopping. This practice is when a patient visits multiple doctors in search for being prescribed narcotics. The change is not allowing these patients to roam freely to whatever doctors they choose. They will be limited to only a number of doctors and only a few pharmacies in which they are allowed to receive their medications.
With everything that is going on with the epidemic involving prescription drug abuse, this report needs to be taken very seriously. There is no excuse for a lack of "over watching" when it comes to a federally run program like Medicare Part D. Billions of dollars have been used in fraud and the amount of destruction this has caused communities and lives is appalling. Hopefully more will be done to help curb the abuse.