How a Simple Fix to Reduce Aberrant Prescribing Became Not So Simple: In 2014, the government said health providers would have to enroll in Medicare in order to prescribe drugs to seniors and disabled beneficiaries. Delay after delay has pushed back the requirement until 2019....
Back in 2014, federal officials settled on what they thought would be a straightforward fix to curb abusive pill pushing: Require doctors and other health providers to register with the Medicare program in order to prescribe medications for beneficiaries.
That way, the government could screen them and take action if their prescribing habits were deemed improper. Officials figured the modest change would barely ruffle the medical community: Doctors already had to fill out an application, have their credentials verified and enroll to get paid by Medicare for seeing patients, after all.
But this fix, which followed a 2013 ProPublica investigation into questionable prescribing in Medicare, has yet to be implemented. The government now says it needs until 2019 to put it in place — 3 1/2 years longer than initially expected.
“It has definitely been much more challenging” than anticipated, said Jonathan Morse, acting director of the Center for Program Integrity within the Centers for Medicare and Medicaid Services, the federal agency that runs Medicare.
As a result, the government is still covering prescriptions written by doctors who have been kicked out of Medicare and even some who have pleaded guilty to crimes. Three New Jersey doctors who pleaded guilty in July 2013 to charges related to a bribery scheme continued prescribing drugs to Medicare patients the following year, a ProPublica review found.
One of those doctors, Franklin Dana Fortunato, told ProPublica that he was advised that he could continue treating patients between his guilty plea and his sentencing in May 2015.
In addition, at least 40 doctors kicked out of Medicare before 2014 had their prescriptions covered by Medicare’s prescription drug program, known as Part D, that year, a ProPublica analysis shows. [...]conflicts of interest doctor-patient relationship health law policy medicaremedicaid pharmaceuticals public health regulation