It is an unfortunate reality but our country is bilked out of billions of dollars every month. From funds disappearing in Afghanistan to FEMA and Medicare fraud, the lack of oversight, combined with a myriad of other factors, including drug abuse and thievery, has created a real stink hole for the US Government.
The Government Accountability Office (GAO) has discovered a serious and growing public health problem" of fraud and prescription drug abuse in Medicare Part D. This reported by nurse.com.
Legal and Subsidized?
One of the real kickers here is that unlike addiction to heroin and other drugs that have no accepted medical use, addiction to some controlled substances can be financed unknowingly by insurance companies and public programs.
The report by the GAO, the independent and nonpartisan (hard to believe any could exist in Washington, right) congressional watchdog, examined prescriptions for 12 classes of frequently abused controlled substances and two classes of frequently abused non-controlled substances. It found that in 2008, about 170,000 Medicare beneficiaries (1.8% of beneficiaries receiving those 14 categories of drugs) acquired the same class of frequently abused drugs, primarily hydrocodone and oxycodone, from five or more medical practitioners during 2008 at a cost of about $148 million (about 5% of the total cost of those drugs).
Sickening Stats
Of the 170,000 Medicare beneficiaries who received prescriptions from five or more practitioners, about 120,000 (71%) were eligible for Part D benefits based on a disability, according to the GAO. Approximately 122,000 (72%) received a Medicare Low-Income Cost-Sharing Subsidy.
The problem is that federal law does not authorize Part D plans to restrict individuals' access to drugs, "leaving little recourse for preventing known doctor shoppers from obtaining hydrocodone, oxycodone and other highly abused drugs.
I am glad that the GAO recommended that Medicare should consider additional steps such as a restricted recipient program for Medicare Part D that would limit identified doctor shoppers to one prescriber, one pharmacy or both for receiving prescriptions. Another step could be the sharing of information about identified doctor shoppers among Part D drug plan sponsors to prevent beneficiaries from circumventing the program by switching plans.
If they implement a proper plan it could help fund more drug classes and rehabilitation as our country tries to avoid being subdues by prescription drug abuse.