A recent report issued by the Government Accountability Office (GAO) on pharmacy-related program-integrity efforts in state Medicaid programs found indicators of potential fraud among beneficiaries, prescribers and pharmacies with questionable patterns related to received, prescribed and dispensed drugs to Medicaid beneficiaries, costing the federal government at least $1.6 million.
As a result, the GAO recommends that the Centers for Medicare & Medicaid Services (CMS) require states to report whether their state has lock-in programs for abusers of non-controlled substances. Lock-in programs limit patients to the use of one prescriber and pharmacy.
In a policy statement, NACDS expressed its ongoing commitment to preventing fraud and abuse, but emphasized that any potential programs should preserve beneficiary choice to ensure continuity of care is provided to all Medicaid beneficiaries.
