Feds Want to Curb Medicare Drug Fraud

The Centers for Medicare and Medicaid Services announced a proposed strategy to stop waste and abuse in the program.

A doctor writes prescriptions for drugs
National Journal
Clara Ritger
Jan. 6, 2014, 1 p.m.

The fed­er­al gov­ern­ment wants to crack down on pre­scrip­tion-drug fraud.

Tax­pay­ers spent $62 bil­lion in 2012 on Medi­care Part D, the pro­gram to re­duce the cost of pre­scrip­tion drugs for seni­ors and the dis­abled. ProP­ub­lica ran a series de­tail­ing the fraud­u­lent activ­ity with­in the pro­gram, and on Monday, the Cen­ters for Medi­care and Medi­caid Ser­vices pro­posed a rule to crack down on the ab­use.

Its strategy would re­quire doc­tors who pre­scribe drugs to Medi­care be­ne­fi­ciar­ies to en­roll in the pro­gram; this would al­low great­er over­sight by CMS, which could call on its in­vest­ig­at­ive team to col­lect in­form­a­tion and take ac­tion should they sus­pect ab­use. The agency also re­serves the right to re­voke li­cens­ing and en­roll­ment.

If im­ple­men­ted, the reg­u­la­tion is sched­uled to take ef­fect on Jan. 1, 2015, but such rule-mak­ings routinely run months or years be­hind sched­ule.

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