Providers excluded from the Medicare Part D Program were allowed to prescribe approximately $15.1 million worth of prescription drugs from calendar year 2006-2008, according to an analysis by the Office of Inspector General.
Under federal law, OIG established a nationwide program to exclude certain physicians and other healthcare providers from participation in federal healthcare programs. Excluded individuals include a provider convicted of a criminal offense related to Medicare or any state healthcare program; a criminal offense related to patient abuse or neglect; or a felony related to other healthcare fraud or to the misuse of controlled substances.
An OIG review of payments under the Medicare Part D Program revealed CMS accepted an additional $2 million worth of prescription drugs that may have been written by excluded providers. The OIG determined CMS had inadequate internal controls in place that would have otherwise prevented the improper prescription approvals.
The OIG recommended that CMS reopen and revise calendar year 2006-2008 final payment determinations to remove prescriptions written by excluded providers and update internal controls.
Under federal law, OIG established a nationwide program to exclude certain physicians and other healthcare providers from participation in federal healthcare programs. Excluded individuals include a provider convicted of a criminal offense related to Medicare or any state healthcare program; a criminal offense related to patient abuse or neglect; or a felony related to other healthcare fraud or to the misuse of controlled substances.
An OIG review of payments under the Medicare Part D Program revealed CMS accepted an additional $2 million worth of prescription drugs that may have been written by excluded providers. The OIG determined CMS had inadequate internal controls in place that would have otherwise prevented the improper prescription approvals.
The OIG recommended that CMS reopen and revise calendar year 2006-2008 final payment determinations to remove prescriptions written by excluded providers and update internal controls.
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