Medicare physicians exposed for abusing prescription drugs

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Prescription Drug News(NaturalHealth365) According to Medscape Medical News, a new report on the Medicare drug program – also known as Part D – found that, “More than 700 general-care physicians nationwide are ‘extreme outliers,’ with highly questionable prescribing habits, possibly endangering patient health and wasting staggering sums of money. The report states that, “Many of these physicians prescribed extremely high numbers of prescriptions per beneficiary, which may indicate that these prescriptions are medically unnecessary.”

In effect, what they found was that doctors were completely abusing their patients by grossly overprescribing Class II and III drugs. In fact, it was reported that drugs ordered by the doctors labeled as “extreme outliers” cost Medicare $352 million.

ProPublica exposes Medicare’s corruption

ProPublica obtained data from Medicare’s prescription drug benefit under the Freedom of Information Act and discovered that the new report published may actually be minimizing the issue. For example, tax-payer funded Medicare approved the following in 2010:

• Beneficiaries with Part D claims: 28 million.
• Average prescriptions per beneficiary: 40.
• Average prescriptions per patient, per provider: 11.
• Nearly three-fourths went to patients 65 and older; the rest were for disabled patients.
• Prescriptions (including refills): 1.1 billion.
• Number of prescribers: 1.7 million.
• Of these providers, 350,000 wrote 50 or more prescriptions for at least one drug.
• Portion of prescribers responsible for writing half of all prescriptions: 3 percent.
• Retail price of all prescriptions: $78 billion.
• Average retail price of a prescription: $70.
• The state with the highest prescription costs: California ($7.1 billion).
• State with the lowest prescription costs: Alaska ($55 million).

Drugs to lower blood pressure and cholesterol top the list

According to the data Medicare provided ProPublica, the number one drug per total claims was Simvastatin, which is prescribed to lower cholesterol. There were 39 million claims for this drug with a total U.S. cost of $680 million. Second, the hypertension drug Lisinopril, was reported at 32 million claims and a total cost of $320 million.

The number one prescribed drug per total cost was Plavix, a blood thinner, which cost tax payers $3.1 billion from the 15 million claims it had in 2010 alone. Second was Lipitor, which is used to lower cholesterol. It cost the United States $2.3 billion from 14 million claims.

Medicare insists they are innocent and blames the medical community

According to ProPublica, “Officials at the Centers for Medicare and Medicaid Services say the job of monitoring prescribing falls to the private health plans that administer the program, not the government. Congress never intended for CMS to second-guess doctors – and didn’t give it that authority, officials said.”

“CMS’s payments don’t go to physicians, and they don’t go to pharmacies. They go to plans, which is how our oversight framework has been established,” Jonathan Blum, the agency’s director of Medicare, said in an interview. The philosophy “really has been to defer to physicians” the right to make prescription decisions based on their opinion alone.

ProPublica has created an online tool, which gives everyone access to what the drug prescribing profile looks like for almost every physician in the U.S. Check it out and make sure your physician is doing what is right.

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Sources:
http://www.medscape.com/viewarticle/806740
http://www.propublica.org/article/part-d-prescriber-checkup-mainbar
http://projects.propublica.org/checkup/
http://www.medscape.com/viewarticle/781537

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  • harh

    This is a shame, not only is a waste of money but people get even sicker by taking those drugs. Change your diet, change your life, all that money could be save with just a little education on diet and exercise. We now have gyms that cost as little as 10 dollars per month. “Truth is not for the masses, is not even for the many, truth is for those who seek it” This adagio applies very much to medicine and food as well of course to Spiritual matters.