HHS Inspector General Daniel Levinson's office audited all $185 billion in drugs that were prescribed during the first 3 years of the new prescription-drug benefit program, known in government circles as Medicare Part D, and found that a narrow share—less than 1%—was ordered by doctors prohibited from prescribing between 2006 and 2008.
Auditors pinpointed several inadequate internal controls that allowed at least $15.1 million in prohibited prescriptions to be dispensed to patients, including the CMS' past practice of not allowing its prescription-drug contractors access to a central database of prohibited prescribers. Auditors also criticized the HHS contractors' use of state indentifiers in screening databases instead of unique national provider identifier numbers.
Read more at: http://tinyurl.com/7hh94hh
Source: Modern Healthcare
In part because of past shortcomings in a centralized database, the Centers for Medicare & Medicaid Services (CMS) and its contractors that administer the Medicare prescription-drug benefit have allowed more than $15 million worth of drugs to be dispensed to patients by doctors whose past criminal activity should have barred them from prescribing, according to a new report (PDF).
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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