In CMS
Mar 14th, 2018
We’ve seen a surge of Department of Justice (DOJ) takedowns of doctors who committed prescription fraud and abuse of opioid drugs. As prescription opioid addiction grows, so does the crackdown on abuse of federal dollars funding physicians who are feeding patient addiction. On March 9, 63-year-old Jerrold N. Rosenberg, MD, of Rhode Island was sentenced ...
In Audit
Mar 7th, 2018
A federal jury found a 78-year-old Biloxi, Mississippi physician guilty for his role in a $3 million pharmacy fraud scheme, which included military healthcare funds. According to the Department of Justice (DOJ) press release on March 5, the 78-year-old physician, Albert Diaz, was convicted of: One count of conspiracy to commit healthcare fraud; Four counts of distributing ...
Apr 4th, 2017
In an ongoing effort to strengthen the Medicare Advantage and the Prescription Drug Program by supporting flexibility, efficiency, and innovation, the Center Medicare & Medicaid Services (CMS) released final updates to the Medicare Advantage and Part D Prescription Drug Program for 2018. The final policies are similar to the proposal released in February’s 2018 Advance Notice ...
Jan 22nd, 2016
The Centers for Medicare and Medicaid Services (CMS) finalized a rule on January 21 that explained reforms to the Medicaid prescription drugs rebate and reimbursement systems. It’s estimated that the federal and state governments will save $2.7 billion over five years. The reform aims to increase rebates and set limits on federal reimbursements for Medicaid prescription drugs. According to ...
In Audit
Dec 15th, 2011
Part D prescription fraud is the latest target of efforts to continue identifying, preventing, and recovering fraud, the Centers for Medicare & Medicaid Service (CMS) announced Dec. 13. CMS is asking Part D prescription drug plan sponsors to stop drug misuse and fraud, especially with pain killers like OxyContin, which are the fifth most filled class of ...