Responsibility for fraud prevention belongs to everyone, especially health care professionals who care for the frail elderly. These professionals are the first people to whom their older patients turn for advice. For this reason, health care providers need to recognize fraud and should advise their patients appropriately.
Now that the federal gover nment is paying a significant portion of prescription drug expenses for the elderly, it is considered fraudulent for pharmaceutical companies to use incentives to encourage the use of expensive branded products. Attention is being focused on pharmaceutical patient assistance programs (PAPs) and pharmacy rebates.
Unfortunately, Medicare beneficiaries and the PDPs that serve them are not the only ones who might be benefiting from the $740 billion expansion of the Medicare program. Medicare fraud involves cheating either the federal government or the beneficiaries. Perhaps the worst form of fraud affects these frail elders, who can hardly afford to be cheated. [...]
INTRODUCTION Now that the Medicare Part D program has begun, attention is being focused on maintaining the integrity of this complex program. Because the Medicare Modernization Act (MMA) of 2003 represents the largest expansion of Medicare since the program’s inception approximately 40 years ago, it is inevitable that not everyone involved with Medicare Part D [...]
