CMS Announces Plans To Improve Efforts To Prevent Fraud in Medicare Prescription Drug Discount Card Program
The federal government is stepping up efforts to prevent fraud and abuse in the new Medicare prescription drug discount card program in the wake of reports of scams in about 13 states, CMS Administrator Mark McClellan said Thursday, the Washington Post reports. According to McClellan, CMS already has investigated 20 cases of potential fraud involving attempts to sell fake discount cards or to obtain private information from beneficiaries that could be used to file false claims (Faler, Washington Post, 4/23). Enrollment in the discount card program will begin May 3, and the program itself will begin in June. "Solicitations taking place now are not approved by Medicare," CMS officials said, the Hartford Courant reports (MacDonald, Hartford Courant, 4/23). McClellan added that the government does not allow companies sponsoring the cards to solicit customers through cold calls or door-to-door visits, and beneficiaries who receive such offers should notify CMS or local law enforcement officials of the scam. Next month, CMS will begin monitoring drugs and drug prices offered through the program and posting weekly updates on its Web site to prevent "bait-and-switch" tactics by pharmaceutical companies. In addition, CMS will collect and respond to complaints from the public of possible scams through its Web site, its 1-800-MEDICARE telephone line and local affiliates across the United States (Washington Post, 4/23). The agency also will conduct spot checks on the companies offering the cards to ensure they are following federal guidelines and will use a "mystery shopper" to call the cards' toll-free numbers to ensure they are charging advertised enrollment fees (Norman, Des Moines Register, 4/23).
"We need to assume that there's going to be people out there who will, unfortunately, try to take advantage of every effort we make to help seniors, and we're going to do all we can to prevent it. We've not seen any evidence of widespread fraud so far, and we intend to keep it that way," McClellan said (Washington Post, 4/23). HHS Secretary Tommy Thompson said, "We have been working closely with health care providers and our partners in law enforcement and oversight to reduce fraud and abuse in Medicare, and we are extending those efforts to Medicare's new programs" (Hartford Courant, 4/23). Sen. Chuck Grassley (R-Iowa) on Thursday called on the Bush administration to form an interagency task force to "directly and proactively target the fraud that could seep into Medicare's new prescription drug program." McClellan did not endorse Grassley's plan but said, "It's a great idea to make sure we're working closely together across agencies, and we're going to make sure that happens" (Washington Post, 4/23).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.