Congressional investigators found that 170,000 Medicare Part D beneficiaries may have undertaken fraud-related “doctor shopping” in 2008 to obtain $148 million worth of frequently abused prescription drugs.
Medicare pays $148 million for excessive drug use: GAO
The beneficiaries acquired the same class of pharmaceuticals from among 14 frequently abused categories through at least five physicians over the course of the year, according to a Government Accountability Office report requested by members of Congress.
The GAO report recommended CMS implement a restricted recipient program for beneficiaries who doctor shop and seek congressional authority to limit those beneficiaries' access to highly-abused drugs.
“Incredibly, when faced with evidence of this so-called doctor shopping, CMS' standard response is simply to send an educational letter to the doctors,” Sen. Scott Brown (R-Mass.), one of the senators to request the report, said in a written statement. “CMS must immediately increase its oversight of this important program and begin notifying proper law enforcement agencies of potential abuses.”
Medicare administrators responded to the GAO findings by agreeing the program needs to curb drug abuse but rejected the use of a restricted recipient program because the report provided no evidence that the approach was more effective than the existing use of drug utilization review requirements.
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.