Inspector General Report: $30 Million of Medicare invoices for HIV drugs may be fraudulent

The Inspector General of the Department of Health and Human Services says that $30 million paid by Medicare for HIV drugs in 2012 may be questionable and fraudulent.  The payments were made under the Medicare Part D programAccording to the Washington Post, reporting on the IG report, in Detroit, a 77-year-old woman purportedly filled $33,500 worth of prescriptions for 10 different HIV medications. But there’s no record that she had HIV or that she had visited the doctors who wrote the scripts.

A 48-year-old in Miami went to 28 pharmacies to pick up HIV drugs worth nearly $200,000, almost 10 times what average patients get in a year. The prescriptions were supposedly written by 16 health providers.

 Another  patient received $17,500 worth of HIV drugs — and none the rest of the year. She acquired more than twice the recommended dose of five HIV drug ingredients.

A ProPublica series last year showed that Medicare’s lax oversight has enabled doctors to prescribe massive quantities of inappropriate medications, wasted billions on needlessly expensive drugs and exposed the program to rampant fraud. Part D cost taxpayers about $65 billion in 2013.

Previous inspector general reports have criticized the way Medicare oversees doctors and pharmacies, but this one focuses on patients and potential fraud and abuse.

Jeffrey Newman represents whistleblowers