OIG Report Raises Serious Medicare Part D Fraud, Waste And Abuse Concerns

(By – Jenna C. Bigornia and Melissa A. Wong, Holland & Knight)

Last month, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services released a comprehensive report and data brief detailing its concerns about the ability of Medicare Part D sponsors – as well as the Centers for Medicare & Medicaid Services (CMS) and its Medicare Drug Integrity Contractor (MEDIC) – to detect and prevent fraud, waste and abuse in Medicare Part D.1 The OIG identified two key areas for improvement, specifically: (1) the need to more effectively collect and analyze program data to identify and resolve potential fraud, waste and abuse before it occurs; and (2) the need for more robust oversight to ensure proper utilization and payment within the Part D program. Read more…


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