Medicaid Drug Fraud: Federal Leadership Needed to Reduce Program Vulnerabilities
HRD-93-118
Published: Aug 02, 1993. Publicly Released: Aug 02, 1993.
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Highlights
Pursuant to a congressional request, GAO provided information on prescription drug diversion in the Medicaid Program, focusing on: (1) the extent of diversion activities; (2) the reasons diversion persists; and (3) efforts to combat diversion activities.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Health and Human Services | The Secretary of Health and Human Services should direct the Administrator, Health Care Financing Administration (HCFA), to develop an overall strategy to address prescription drug diversion as part of the larger problem of Medicaid fraud. This would highlight the importance of lessons learned from state initiatives and their applicability to health care in general. One key element of such a strategy might be the designation of a unit within HCFA responsible for: (1) conducting continuing evaluations of state initiatives targeting prescription drug diversion and other Medicaid fraud; and (2) providing guidance and technical assistance tailored to individual state problems. |
HHS originally responded that the recommendation is reasonable but not feasible unless new staff resources can be identified and allocated.
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Topics
Billing proceduresDrugsFraudLaw enforcementLitigationMedicaidPharmaceutical industryProgram abusesRisk managementStaff utilizationPrescription drugs