Medicare Pays $31 Million per Year for Unauthorized Prescription Drugs

Thursday, June 27, 2013

Officials who handle billing for Medicare have been approving thousands of payments each year for unauthorized prescriptions that total more than $30 million.


A new report by the inspector general (I.G.) of the Department of Health and Human Services identified more than 417,000 prescriptions in 2009 alone written by people who aren’t allowed under the law to do so, like massage therapists, athletic trainers, interpreters and others.


The cost of the unauthorized prescriptions was $31.6 million, according to the study.


About 30,000 of the prescriptions were for painkillers and other drugs that are commonly abused by patients. These mistakes could “endanger patients” and “may also contribute to the prescription drug abuse problem in our nation,” the report said.


One example that the study highlighted is a Florida dietician who, in a single year, ordered about 2,600 prescriptions for 165 patients.


“Although [the $31.6 million is] just a small fraction of total drug spending in the program, known as Part D, it raises questions about how closely Medicare tracks the validity of prescriptions or investigates those that appear suspicious,” wrote Jennifer LaFleur, Tracy Weber and Charles Ornstein of ProPublica.


Last week, the I.G.’s office reported (pdf) that it had identified more than 700 doctors found to have a history of possibly dangerous drug prescribing activity, and it urged Medicare to investigate them.

-Noel Brinkerhoff


To Learn More:

Not Authorized to Prescribe Drugs? Medicare Pays Anyway (by Jennifer LaFleur, Tracy Weber and Charles Ornstein, ProPublica)

Medicare Inappropriately Paid for Drugs Ordered by Individuals without Prescribing Authority (by Daniel R. Levinson, Office of Inspector General, Department of Health and Human Services)

Medicare Drug Program Fails to Monitor Prescription Safety (by Noel Brinkerhoff, AllGov)    

Quota-Driven Pharmacies Refill Prescriptions without Patient Oks (by Ken Broder, AllGov California)      

Private Insurance Companies Cost Medicare $34 Billion This Year (by David Wallechinsky, AllGov)


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