…TO AFFECT CHANGES IN EFFORTS BY GOVERNMENT AGENCY TO DETECT AND DETER HAZARDOUS MEDICATION PRESCRIBING PRACTICES BY DOCTORS WHO TREAT MEDICARE RECIPIENTS AND THE DISABLED
Propublica.com, an independent, non-profit newsroom that produces investigative journalism in the public interest, announced today that two years after the watchdog group initially reported that the Centers for Medicare and Medicaid Services (CMS) had “done little to detect or deter hazardous prescribing of medication to Medicare recipients and the disabled,” CMS has developed a new online tool called, Prescriber Checkup, which lets users find and compare doctors and other providers of Medicare prescription services in the same specialty and state.
The new Prescriber Checkup tool will provide research scientists, patients and providers that administer Medicare drug programs, with instant access to information that is designed to, “help shape the future of our nation’s health for the better,” according to one CMS administrator who was involved in the development of the new online tool.
ProPublica.org said of its earlier report that it had analyzed several years’ worth of prescription data obtained under the Freedom of Information Act. The report, according to ProPublica.org, uncovered deficiencies in CMS’ ability to properly monitor the 1.4 billion prescriptions that were written for Medicare recipients and the disabled in 2013, as part of what is known as Medicare Part D.
“Clearly, Medicare changed its approach to overseeing Part D after the ProPublica.org reports,” Jay Dankner, managing partner of the New York based top medical malpractice law firm of Danker Milstein, P.C. said.
“Since their reports,” he added, “CMS has gone to considerable lengths to address and repair the blind spots and excesses in Part D. We are very happy to see that happen, given the number of cases we have handled where our client had been injured due to drug prescriber malpractice and came to us seeking help and legal representation.”
According to ProPublica.org, in May 2014, CMS assumed the authority to expel physicians from Medicare if they are found to prescribe drugs to Medicare recipients and the disabled in abusive ways.
“We are also pleased to see,” Danker added, “that beginning next month CMS will require health providers to enroll in Medicare before they are allowed to prescribe medications for patients in Part D. This step will go a long way in closing a loophole that has allowed some healthcare providers to operate with little or no oversight.”
The following are two additional findings from the original ProPublica.org report:
Medicare wasted hundreds of millions of dollars a year by failing to penalize doctors who routinely gave patients prescriptions for much more expensive name-brand drugs when cheaper generic alternatives are available. The original ProPublica.org report identified top prescribers of some brand name drugs who received speaking payments from the companies that manufactured the drugs.
Medicare’s process of flagging fraud was so convoluted and ineffective that the program was losing millions of dollars to schemes.
ProPublica.org said that prior to the publication of their original report, agency officials insisted that monitoring problem prescription patterns fell to the private health plans that administer the program, not the government itself. The CMS claimed that Congress never intended for CMS to second-guess doctors – and didn’t give it that authority.
Doctors didn’t even have to be enrolled in Medicare to prescribe to patients in Part D, making it impossible for the CMS to know basic facts about whether the prescriptions these doctors wrote were appropriate.
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