Keeping you updated on the latest Medicare and Part D news

OIG: Part D Needs More Oversight

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A new report exposes hundreds of physicians with questionable prescribing patterns in Medicare Part D. The study used 2009 PDE data to measure prescribers on the average number of prescriptions per beneficiary, the total number of pharmacies associated with each prescriber, the percentage of precriptions that were Schedule II or Schedule III drugs, and the percentage of prescriptions that were for brand names. In all, the study found over 700 extreme outlier prescribers.

Here are some findings:

  • 24 doctors wrote more than 400 prescriptions for at least one patient, including refills dispensed. The average doctor wrote 13 per patient.
  • An Illinois doctor had prescriptions filled by 872 pharmacies in 47 states and Guam. General-care doctors, on average, had prescriptions for all their Medicare patients filled by 52 pharmacies.
  • Medicare paid $9.7 million for the prescriptions of one California doctor alone — that is 151 times more than the cost of an average doctor’s tally. Most of this physician’s drugs were supplied by two pharmacies, both of which the inspector general had identified previously as having questionable billing practices.
  • The drugs ordered by the doctors labeled extreme outliers cost Medicare $352 million.

Read full report here



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