Medicare fraud is a huge problem in the United States, as I’ve written about several times before. The good news is that Congress finally seems to be figuring this out — probably because of the federal budget situation. Whatever the reason, any exposure of this situation is good, and Iowa Senator Charles Grassley is calling for a review of doctors with abnormally high rates of prescriptions written for mental health drugs. Here are excerpts from an article in Bloomberg Businessweek:
U.S. Sen. Charles Grassley of Iowa studied Medicare and Medicaid prescription rates from doctors around the country, revealing few consequences for doctors with high prescription rates. The findings include a Miami doctor who wrote nearly 97,000 prescriptions in 18 months for mental health drugs for Medicaid patients and an Ohio physician who wrote about 102,000 prescriptions in two years. A Texas doctor wrote 14,170 prescriptions for the anti-anxiety drug Xanax in 2009, far exceeding other high prescribers in that state.
“The federal government has an obligation to figure out what’s going on here. The taxpayers are footing the bill, and Medicare and Medicaid are already strained to the limit,” Grassley said in an email to The Associated Press on Wednesday. “These programs can’t spare a dollar for prescription drugs that aren’t properly prescribed. The conclusion might be that there isn’t any fraud, but it’s important to reach a conclusion one way or the other and fix whatever is broken.”
Grassley sent a letter Wednesday asking Department of Health and Human Services Sec. Kathleen Sebelius to explain how the agency ensures contractors are properly monitoring and reporting the data. He also asked her to explain why “possible overutilizers” are treated differently than those suspected of fraud.
