Government investigators pinpoint $5.6 billion in 'suspect' Medicare billings from pharmacies

This report from the Health and Human Services inspector general concluded that corner drugstores are vulnerable to fraud.

The Associated Press: Suspect Billings At 2,600 Drugstores
Medicare paid $5.6 billion to 2,600 pharmacies with questionable billings, including a Kansas drugstore that submitted more than 1,000 prescriptions each for two patients in just one year, government investigators have found. The new report by the inspector general of the Health and Human Services department finds the corner drugstore is vulnerable to fraud, partly because Medicare does not require the private insurers that deliver prescription benefits to seniors to report suspicious billing patterns (Alonso-Zaldivar, 5/10).

In other Medicare news, the government has identified hospitals where Medicare patients incur very high bills, and the Obama administration is expected to announce today a plan to regularly review rules, including outdated hospital reporting requirements, that could result in big savings.

Kaiser Health News: Medicare Spotlights Hospitals With Especially Costly Patients
The government has identified hundreds of hospitals whose Medicare patients are incurring especially high bills, a first step toward using bonuses and penalties to encourage more efficient care (Rau, 5/9).

The Associated Press: Obama To Require Regular Reviews Of Federal Rules
The Obama administration is changing or eliminating a handful of regulations -- from uniform street sign requirements to outdated hospital reporting rules -- that it says could have cost the economy $6 billion over five years, part of a regulatory overhaul that will require agencies to periodically scrub their rule books in search of unnecessary mandates. ... Among the five finalized rule changes that are to be announced Thursday, some of the biggest saving come in changes that do away with unnecessary reporting requirements by hospitals that treat Medicare and Medicaid patients (Kuhnhenn, 5/10).