Senate to look at questionable prescribing practices under Medicare Part D drug program

A Senate committee is scheduled to meet Monday afternoon to discuss problems of questionable prescribing practices under the Medicare Part D program. A recent report found that more than 700 doctors had unusually high prescribing patterns, and more half of them tended to scribble scripts for controlled substances.

Part D is the prescription drug portion of Medicare, the federal government's insurance program for people age 65 and older, along with some younger people who are disabled. Taxes pay for Medicare, generally. However, when President Bush pushed through Medicare Part D - which cost the federal government $62 billion in 2012 - he did not push through extra taxes to pay for it.

Not surprisingly, seniors like discounted medication.

Nonetheless, the cost, efficiency and administration of the program by the Centers for Medicare and Medicaid (CMS) is a constant source of political debate. Everybody says they dislike waste and fraud. But your waste is somebody else's income or payment for medicine or care.

Monday's discussion will be under the auspices of the Senate Homeland Security and Governmental Affairs Committee, chaired by Tom Carper (D-Del.). The ranking Republican on the committee is Tom Coburn (Okla.).

Some of Monday's discussion will be about by a report issued last week by the Office of Inspector General of the Department of Health and Human Services. The report deals not only with unusual prescribing patterns by hundreds of doctors, but also points to the increasing problem of drug abuse of prescription medicine. Though the common assumption is that drug abuse occurs with young people, the misuse of opioid painkillers includes Medicare beneficiaries.

The report, a link to which is here, found:

"Over 1 million individual prescribers ordered drugs paid by Part D in 2009. Prescribing patterns varied widely by specialty. Over 700 general-care physicians had questionable prescribing patterns. Each of these physicians prescribed extremely high amounts for at least one of the five measures we developed. For example, many of these physicians prescribed extremely high numbers of prescriptions per beneficiary, which may indicate that these prescriptions are medically unnecessary. Moreover, more than half of the 736 general-care physicians with questionable prescribing patterns ordered extremely high percentages of Schedule II or III drugs, which have potential for addiction and abuse. Although some of this prescribing may be appropriate, such questionable patterns warrant further scrutiny."

The video below is the speech given by HHS Inspector General Daniel R. Levinson in April to the Health Care Compliance Association, a group composed of compliance officials from healthcare companies.