A report issued on May 10th by the inspector general of the Health and Human Services department showed that because Medicare doesn't require the private insurers that deliver prescription benefits to seniors to report suspicious billing patterns, fraud often results at the corner drugstore.
According to an article on delmarvanow.com, "Medicare paid $5.6 billion to 2,600 pharmacies with questionable billings, including a Kansas drugstore that submitted more than 1,000 prescriptions each for two patients in just one year, government investigators have found."
The inspector general's report said that "While some pharmacies may be billing extremely high amounts for legitimate reasons, all warrant further scrutiny."
In a written response, Medicare administrator Marilyn Tavenner said the agency "mostly agrees with the inspector general's call to action." "We believe it is important to note that (the inspector general's) report identified what appeared to be questionable billing based on its own data analysis but did not determine any actual fraud committed by the pharmacies," she wrote.
However the inspector general's office says its findings are legitimate. A regional inspector general in New York who directed the research, Jodi Nudelman, said, "What we are seeing in the data is extremely concerning."
