Doctors Fraudulently Prescribe Addictive Drugs, Bill Medicare

Doctors Fraudulently Prescribe Addictive Drugs, Bill Medicare

Too many doctors are prescribing large quantities of narcotics and addictive drugs that may be finding their way onto the streets, or putting patients at risk of addiction. The doctors, in turn, are accepting kickbacks and other "incentives" while billing Medicare for the cost. The following are just three of the examples from a new report from the Department of Health and Human Services Office of Inspector General:

  • A California physician ordered 115 Schedule II drugs (the class at highest risk for addiction) for just one beneficiary in 2009. Medicare paid $425,711.
  • Seventy-eight percent of the prescriptions ordered by one Florida physician were for Schedule II drugs. For one beneficiary, this physician prescribed a 605-day supply of morphine, a 524 - day supply of oxycodone, a 460 - day supply of fentanyl, and a 347 - day supply of hydromophone.
  • An Ohio physician ordered more than 400 drugs each for 13 of his 665 patients. In total, this physician ordered 50,430 drugs dispensed by 100 pharmacies in 18 states.

The report analyzed the prescribing patterns of the nation's one million doctors and found that 736 of them had questionable patterns. The drugs prescribed included highly addictive prescriptions for morphine, oxycodone, anabolic steroids, hydrocodone with codeine, and barbiturates. Doctors, and crooks who use stolen provider identification numbers are writing multiple prescriptions for the same patients that are filled by dozens of pharmacies.

TSCL believes the drug problem could explode this year. Citing massive "sequester" budget and staff cuts, federal officials are set to scale back or drop investigations into Medicare and Medicaid fraud and abuse cases. The Department of Health and Human Services may lose a total of 400 staffers and the existing staff is stretched so thin that it was unable to investigate about 1,200 cases of Medicare and Medicaid fraud and abuse last year.

TSCL strongly supports The PRIME Act, bipartisan legislation that would prevent the loss of billions in Medicare dollars every year. The PRIME act would make it more difficult to misuse Medicare provider billing information used in prescriber fraud. The legislation also requires the Center for Medicare and Medicaid Services and law enforcement to take steps to curb the use of stolen physician identities.

Medicare investigations returned $8 for every dollar invested in recent years. Let's tell Congress to stop being so "penny wise and pound foolish." Sequester cuts are like writing a blank check for crooks, and have no place in Medicare fraud control programs. Ask your Member of Congress to cosponsor The PRIME Act (H.R. 2305) and (S.1123.)

Sources: "Prescribers With Questionable Patterns In Medicare Part D," Department of Health and Human Services Office of Inspector General, June 2013. "Medicare Fraud Outrunning Enforcement Efforts," The Center For Public Integrity, July 3, 2013.