Saturday, April 9, 2011

There is Money in Medicare Fraud

Wanna get high? 

"Fraud found in Medicare drug program" February 12, 2011|Associated Press

MIAMI — Crooks are taking advantage of lax oversight in Medicare’s Part D prescription drug program to obtain highly addictive drugs including oxycodone, Ritalin, and methadone, according to results of a federal probe.

The report by an independent inspector said Medicare can’t verify all the prescriptions it pays for, leaving the system open to exploitation by criminals using fake medical ID numbers and the identities of dead doctors....

Pharmacies and other Medicare contractors are supposed to enter a number that identifies prescribers. But in many cases, that information is being left blank or assigned a dummy number, last week’s report found. The missing information doesn’t always indicate fraud and could include clerical errors, but without prescriber identifiers, it’s hard for investigators to determine....  

Investigators said the prescriptions with invalid IDs represented a small portion, but are alarming because schedule II drugs include heavy-duty painkillers and stimulants that are frequently trafficked.

Critics say pharmacies are getting around safeguards in the system, making it nearly impossible for federal health officials to track whether a licensed doctor prescribed the drug and in what quantities....   

What, with all that spying technology they can't track the $$? 

Or maybe they just don't want to seeing where it ends up.

Investigators recommended that contractors not be paid for Schedule II prescriptions that have an invalid doctor ID number, but Medicare officials worried stricter oversight could hamper legitimate patients’ access to medications.

The agency later agreed to validate all provider numbers and this month will tell contractors they will be required to use a Drug Enforcement Administration number or other valid prescriber identifier, spokesman Peter Ashkenaz said.

Doctors must have a DEA number to prescribe Schedule II drugs.

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"US arrests dozens in a crackdown on Medicare fraud; Suspects accused of bilking system of at least $225m" by Kelli Kennedy, Associated Press / February 18, 2011

MIAMI — Federal authorities charged more than 100 doctors, nurses, and physical therapists in nine cities with Medicare fraud yesterday, part of a massive nationwide bust that snared more suspects than any other in history.

More than 700 law enforcement agents fanned out to arrest dozens of people accused of illegally billing Medicare more than $225 million.

The arrests are the latest in a string of major busts in the past two years as authorities have struggled to pare the fraud that is believed to cost the government between $60 billion and $90 billion each year. Stopping Medicare’s budget from hemorrhaging that money will be key to paying for President Obama’s health care overhaul....

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