Friday, December 20, 2013

More money available from Medicare Part D

A month ago I wrote about Medicare's failure to take advantage of the far lower cost of generic drugs bought through Part D. This failure cost us $300,000,000 a year. Today, ProPublica reports on more shenanigans re Part D - fraud.
Again, we're talking millions of our dollars going down the drain because of poor management by our employees. Credit card companies routinely scan their records for fraud, flagging or blocking suspicious charges as they happen. Medicare can't do that. Thus, there are those doctors whose prescription volume can double, triple, etc. in one year, but Medicare does not do anything about it, like looking into the reason for the rise.
Part D payments are made by insurance companies. However, if insurers suspect fraud, Medicare encourages — but does not require — them to notify its Part D fraud contractor, a private firm hired to review complaints and recommend cases for investigation. The insurers, however, are not allowed to block a suspect doctor's prescriptions. There is no attempt made to determine whether other insurance companies are paying exorbitant money to the suspected doctor.
Does Congress really want to reduce the deficit?

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